Provider Demographics
NPI:1750981197
Name:LOWE, TIMOTHY (LPC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:LOWE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:TIMOTHY
Other - Middle Name:
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:240 E WESTFIELD AVE APT C18
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-2326
Mailing Address - Country:US
Mailing Address - Phone:732-857-0399
Mailing Address - Fax:
Practice Address - Street 1:240 E WESTFIELD AVE APT C18
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-2326
Practice Address - Country:US
Practice Address - Phone:732-857-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00715600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health