Provider Demographics
NPI:1063873636
Name:STOWE, DANIEL (LLMSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:STOWE
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 AUSTIN
Mailing Address - Street 2:
Mailing Address - City:CASSOPOLIS
Mailing Address - State:MI
Mailing Address - Zip Code:49031-8310
Mailing Address - Country:US
Mailing Address - Phone:269-228-5141
Mailing Address - Fax:269-445-3836
Practice Address - Street 1:610 S BURDICK ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007
Practice Address - Country:US
Practice Address - Phone:269-381-3700
Practice Address - Fax:269-381-3810
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802087970104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker