MEDICARE: DR. JAMES HOWARD LOWERY PHD, HSPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	20010264	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20010264	OTHER		HSPP CERTIFICATION

General Provider Information

NPI Number	:	1467468348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES HOWARD LOWERY PHD, HSPP

Provider Business Mailing Address
First Line	:	3500 DEPAUW BLVD STE 3070
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-6135
Country	:	US
Telephone Number	:	855-324-0885
Fax Number	:	765-450-6664

Provider Business Practice Location Address
First Line	:	6635 EAST 21ST STREET
Second Line	:	SUITE 100, WEST BLDG.
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-2254
Country	:	US
Telephone Number	:	317-608-2824
Fax Number	:	765-450-6664

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/21/2022

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