Provider Demographics
NPI:1487689501
Name:LOWENBERG, PAT L (LISW)
Entity type:Individual
Prefix:MS
First Name:PAT
Middle Name:L
Last Name:LOWENBERG
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:IA
Mailing Address - Zip Code:50830-0361
Mailing Address - Country:US
Mailing Address - Phone:641-347-5060
Mailing Address - Fax:641-347-5060
Practice Address - Street 1:505 E TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-4057
Practice Address - Country:US
Practice Address - Phone:641-782-7212
Practice Address - Fax:641-347-5060
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA012501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical