MEDICARE: ASHLEY LOWE 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1881441053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLEY LOWE LLC

Provider Business Mailing Address
First Line	:	4182 WORTH AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-1535
Country	:	US
Telephone Number	:	614-795-5534
Fax Number	:

Provider Business Practice Location Address
First Line	:	4182 WORTH AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-1535
Country	:	US
Telephone Number	:	614-795-5534
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	DR. ASHLEY LOWE-SIMMONS
Credential	:	LCSW
Telephone Number	:	614-795-5534

Provider Enumeration Date	:	05/04/2024
Last Update Date	:	05/04/2024

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