Healthcare Provider Details

I. General information

NPI: 1770088684
Provider Name (Legal Business Name): JENNIFER LOWE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2018
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 BARBARA LN
WAPPINGERS FALLS NY
12590-5302
US

IV. Provider business mailing address

7000 AUSTIN ST
FOREST HILLS NY
11375-1022
US

V. Phone/Fax

Practice location:
  • Phone: 347-805-7062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102414
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: