Provider Demographics
NPI:1427692664
Name:LOWRY, JESSICA ANN (LPCA)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:ANN
Last Name:LOWRY
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 WINTERGREEN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-5121
Mailing Address - Country:US
Mailing Address - Phone:323-309-9727
Mailing Address - Fax:
Practice Address - Street 1:5010 RANDALL PKWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2829
Practice Address - Country:US
Practice Address - Phone:910-791-5719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15211101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health