Provider Demographics
NPI:1932759966
Name:STOWELL, TERRI-LYNN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:TERRI-LYNN
Middle Name:
Last Name:STOWELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 MORRELL BLVD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1512
Mailing Address - Country:US
Mailing Address - Phone:928-642-8208
Mailing Address - Fax:
Practice Address - Street 1:1000 AINSWORTH DR STE C-20
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1667
Practice Address - Country:US
Practice Address - Phone:928-642-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ177071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical