Healthcare Provider Details

I. General information

NPI: 1548220502
Provider Name (Legal Business Name): LOWELL EDWARD THOMAS III LPC; LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 N PARHAM RD STE 5
RICHMOND VA
23229-3171
US

IV. Provider business mailing address

9629 SOUTHMILL DR
GLEN ALLEN VA
23060-9212
US

V. Phone/Fax

Practice location:
  • Phone: 804-270-1124
  • Fax: 804-270-2090
Mailing address:
  • Phone: 804-873-1552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002023
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: