Provider Demographics
NPI:1134233737
Name:LOWRY, REBECCA KELLEY (LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:KELLEY
Last Name:LOWRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 BETHESDA PL STE 604A
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3314
Mailing Address - Country:US
Mailing Address - Phone:336-794-4008
Mailing Address - Fax:336-712-1796
Practice Address - Street 1:2990 BETHESDA PL STE 604A
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3314
Practice Address - Country:US
Practice Address - Phone:336-794-4008
Practice Address - Fax:336-712-1796
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4137101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional