Provider Demographics
NPI:1598369977
Name:LOWE, DAVID M (LCSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:LOWE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 W 2000 N
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1243
Mailing Address - Country:US
Mailing Address - Phone:801-367-4356
Mailing Address - Fax:
Practice Address - Street 1:655 E 400 S STE D
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-2039
Practice Address - Country:US
Practice Address - Phone:801-367-4356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8154344-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical