Provider Demographics
NPI:1598141764
Name:LOWERY, JONATHAN (LCSW-A, MSW, BSW)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:LOWERY
Suffix:
Gender:M
Credentials:LCSW-A, MSW, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BEREA CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-6561
Mailing Address - Country:US
Mailing Address - Phone:252-258-7712
Mailing Address - Fax:
Practice Address - Street 1:3229 PLEASANT GARDEN RD APT 1E
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-4627
Practice Address - Country:US
Practice Address - Phone:252-258-7712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP009782171M00000X
NCPO159141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator