MEDICARE: MICHELLE LOWERY MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1255269122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELLE LOWERY MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	2801 PINCKARD AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-1534
Country	:	US
Telephone Number	:	323-544-3737
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 PINCKARD AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-1534
Country	:	US
Telephone Number	:	323-544-3737
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHELLE LOWERY
Credential	:	LMFT
Telephone Number	:	323-544-3737

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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