Healthcare Provider Details

I. General information

NPI: 1083532014
Provider Name (Legal Business Name): TIMOTHY ROBERT STOW LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4139 OREGON PIKE STE 303
EPHRATA PA
17522-9577
US

IV. Provider business mailing address

4139 OREGON PIKE STE 303
EPHRATA PA
17522-9577
US

V. Phone/Fax

Practice location:
  • Phone: 855-256-9177
  • Fax: 412-655-6511
Mailing address:
  • Phone: 413-930-3175
  • Fax: 412-655-6511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC019480
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: