Healthcare Provider Details

I. General information

NPI: 1215333448
Provider Name (Legal Business Name): LESLIE LOWER, LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2014
Last Update Date: 11/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 UPTOWN SQ
MURFREESBORO TN
37129-0574
US

IV. Provider business mailing address

PO BOX 69
CHRISTIANA TN
37037-0069
US

V. Phone/Fax

Practice location:
  • Phone: 615-603-9057
  • Fax: 615-625-2976
Mailing address:
  • Phone: 615-603-9057
  • Fax: 615-625-2976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6008
License Number StateTN

VIII. Authorized Official

Name: MRS. LESLIE S LOWER
Title or Position: OWNER OPERATOR
Credential: LCSW
Phone: 615-603-9057