Healthcare Provider Details

I. General information

NPI: 1255269122
Provider Name (Legal Business Name): MICHELLE LOWERY MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 PINCKARD AVE
REDONDO BEACH CA
90278-1534
US

IV. Provider business mailing address

2801 PINCKARD AVE
REDONDO BEACH CA
90278-1534
US

V. Phone/Fax

Practice location:
  • Phone: 323-544-3737
  • Fax:
Mailing address:
  • Phone: 323-544-3737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE LOWERY
Title or Position: CEO
Credential: LMFT
Phone: 323-544-3737