MEDICARE: MARK LOEWEN LPC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	0701004844	VA

General Provider Information

NPI Number	:	1205242880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK LOEWEN LPC, LLC

Provider Business Mailing Address
First Line	:	5540 FALMOUTH ST
Second Line	:	SUITE 100
City	:	RICHMOND
State	:	VA
Zip	:	23230-1800
Country	:	US
Telephone Number	:	804-665-4681
Fax Number	:	888-379-2724

Provider Business Practice Location Address
First Line	:	5540 FALMOUTH ST
Second Line	:	SUITE 100
City	:	RICHMOND
State	:	VA
Zip	:	23230-1800
Country	:	US
Telephone Number	:	804-665-4681
Fax Number	:	888-379-2724

Authorized Official
Title or Position	:	CEO
Name	:	MR. MARK RICHARD WALDE LOEWEN
Credential	:	LPC
Telephone Number	:	804-665-4681

Provider Enumeration Date	:	07/03/2014
Last Update Date	:	12/17/2024

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