Provider Demographics
NPI:1962705319
Name:LOWERY, DESIREE (LCSW)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:LOWERY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5235 W WOODMILL DR
Mailing Address - Street 2:SUITE 47 & 48
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4068
Mailing Address - Country:US
Mailing Address - Phone:302-995-1680
Mailing Address - Fax:302-995-1790
Practice Address - Street 1:5235 W WOODMILL DR
Practice Address - Street 2:SUITE 47 & 48
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4068
Practice Address - Country:US
Practice Address - Phone:302-995-1680
Practice Address - Fax:302-995-1790
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical