Individual provider Active NPI

Persephone Roshall Lowe, LPC, NCC

  • Professional Counselor
  • Olive Branch, MS
National Provider Identifier
1720413479
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1717 Issued in MS
Practice address
9851 Highway 178 Ste a
Olive Branch, MS 38654-3214
Phone
(662) 299-4061
Fax
(662) 874-6809
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1717 MS Primary

Addresses

Primary practice location

9851 Highway 178 Ste a
Olive Branch, MS 38654-3214

Mailing address

9851 Highway 178 Ste a
Olive Branch, MS 38654-3214
Phone (662) 299-4061

Other identifiers 1

IdentifierTypeStateIssuer
822571852MedicaidMS

Other names 1

  • Persephone Roshall Lowe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1717MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lowes Counseling Center, LLC CurrentSince Apr 20, 2021 Accepting new patients

Locations

9851 Highway 178
#A
Olive Branch, MS 38654
Phone (662) 253-8324

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1720413479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9851 HIGHWAY 178 STE A",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543214",
            "telephone_number": "662-299-4061",
            "fax_number": "662-874-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9851 HIGHWAY 178 STE A",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543214",
            "telephone_number": "662-299-4061",
            "fax_number": "662-874-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWE",
        "first_name": "PERSEPHONE",
        "middle_name": "ROSHALL",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "822571852",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PERSEPHONE",
            "last_name": "LOWE",
            "middle_name": "ROSHALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.