MEDICARE: ROCHELLE LOWY LISW

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	1041C0700X	Clinical Social Worker	I-04643	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740376466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCHELLE LOWY LISW

Provider Business Mailing Address
First Line	:	4801 LANG AVE NE
Second Line	:	SUITE 110
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4475
Country	:	US
Telephone Number	:	505-994-2375
Fax Number	:	505-994-2373

Provider Business Practice Location Address
First Line	:	2369 BELLAMAH CT
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507
Country	:	US
Telephone Number	:	505-660-2375
Fax Number	:	505-994-2373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/09/2007

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Directions to “ ROCHELLE LOWY LISW” Practice Location

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