Healthcare Provider Details

I. General information

NPI: 1871351163
Provider Name (Legal Business Name): MICHAEL W LOWE LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3804 GRASSY CREEK DR
LEXINGTON KY
40503-4236
US

IV. Provider business mailing address

3804 GRASSY CREEK DR
LEXINGTON KY
40503-4236
US

V. Phone/Fax

Practice location:
  • Phone: 859-619-8801
  • Fax:
Mailing address:
  • Phone: 859-619-8801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number299830
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: