Healthcare Provider Details

I. General information

NPI: 1598016693
Provider Name (Legal Business Name): DIANE M LOWN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4519 CASCADE RD SE STE 1
GRAND RAPIDS MI
49546-8318
US

IV. Provider business mailing address

107 HONEY CREEK AVE NE
ADA MI
49301-9768
US

V. Phone/Fax

Practice location:
  • Phone: 616-414-1900
  • Fax:
Mailing address:
  • Phone: 616-366-2066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401013187
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301015213
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: