Provider Demographics
NPI:1063294775
Name:LOWE, NATHAN (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:LOWE
Suffix:
Gender:M
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-6927
Mailing Address - Country:US
Mailing Address - Phone:214-952-0684
Mailing Address - Fax:
Practice Address - Street 1:5431 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-4836
Practice Address - Country:US
Practice Address - Phone:972-775-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health