Provider Demographics
NPI:1992434807
Name:LOWE, OLIVIA (LLMSW)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 SPOKANE AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-5449
Mailing Address - Country:US
Mailing Address - Phone:517-249-4253
Mailing Address - Fax:
Practice Address - Street 1:111 E CESAR E CHAVEZ AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-4384
Practice Address - Country:US
Practice Address - Phone:517-273-2706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511147511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical