Basic Information
| Provider Information | |||||||||
| NPI: | 1447870969 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOWENHAR-BLAUWEISS | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PSY.D, LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 124 GREEN ST | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124014422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453313001 | ||||||||
| FaxNumber: | 8453354600 | ||||||||
| Practice Location | |||||||||
| Address1: | 124 GREEN ST | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124014422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453313001 | ||||||||
| FaxNumber: | 8453354600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2020 | ||||||||
| LastUpdateDate: | 04/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | N | Behavioral Health & Social Service Providers | Psychologist | 101YP2500X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.