Provider Demographics
NPI:1912936402
Name:ROWE, JOHN BENSON (MA, LMFT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BENSON
Last Name:ROWE
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 PARK RD STE 310
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2261
Mailing Address - Country:US
Mailing Address - Phone:704-490-4000
Mailing Address - Fax:704-490-4100
Practice Address - Street 1:4108 PARK RD STE 310
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2261
Practice Address - Country:US
Practice Address - Phone:704-490-4000
Practice Address - Fax:704-490-4100
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC498106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC73517OtherBLUECROSS BLUESHEILD