Provider Demographics
NPI:1831520436
Name:LOWERY, DENISE NICOLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:NICOLE
Last Name:LOWERY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3565 ANTIGUA PL
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-5822
Mailing Address - Country:US
Mailing Address - Phone:916-802-3292
Mailing Address - Fax:916-739-0314
Practice Address - Street 1:2950 BEACON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-5032
Practice Address - Country:US
Practice Address - Phone:916-739-0100
Practice Address - Fax:916-739-0314
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA596241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical