Provider Demographics
NPI:1124342001
Name:HOWELL, IVORY SHAE (LPCC, LMHC)
Entity type:Individual
Prefix:
First Name:IVORY
Middle Name:SHAE
Last Name:HOWELL
Suffix:
Gender:F
Credentials:LPCC, LMHC
Other - Prefix:
Other - First Name:IVORY
Other - Middle Name:SHAE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:100 W 3RD ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4135
Mailing Address - Country:US
Mailing Address - Phone:270-302-1669
Mailing Address - Fax:
Practice Address - Street 1:100 W 3RD ST
Practice Address - Street 2:SUITE 304
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4135
Practice Address - Country:US
Practice Address - Phone:270-302-1669
Practice Address - Fax:270-698-9778
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-21
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY104689101YP2500X
IN99128083A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN99128083AOtherINDIANA PROFESSIONAL LICENSING AGENCY BEHAVIORAL HEALTH AND HUMAN SERVICES BOARD