Provider Demographics
NPI:1962571075
Name:LOWNEY, DORETTA JEAN (LICSW)
Entity type:Individual
Prefix:MS
First Name:DORETTA
Middle Name:JEAN
Last Name:LOWNEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 HART ST
Mailing Address - Street 2:APARTMENT #45
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-6929
Mailing Address - Country:US
Mailing Address - Phone:508-884-9982
Mailing Address - Fax:
Practice Address - Street 1:534 ROUTE 44
Practice Address - Street 2:SUITE #4
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-5116
Practice Address - Country:US
Practice Address - Phone:508-884-9982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1031633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22724Medicare ID - Type Unspecified