Provider Demographics
NPI:1003671645
Name:OWENS, AMBER RAE (LMSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:RAE
Last Name:OWENS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 PITTMAN DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-8461
Mailing Address - Country:US
Mailing Address - Phone:931-220-2915
Mailing Address - Fax:
Practice Address - Street 1:113 HAZEL PATH BLDG SUITE3C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3878
Practice Address - Country:US
Practice Address - Phone:615-943-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker