Provider Demographics
NPI:1033413927
Name:LEE F. OWENS, ED.D.
Entity Type:Organization
Organization Name:LEE F. OWENS, ED.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:F
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:410-224-2021
Mailing Address - Street 1:212 BALSAM TREE CT
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2852
Mailing Address - Country:US
Mailing Address - Phone:410-224-2021
Mailing Address - Fax:410-224-2420
Practice Address - Street 1:116 DEFENSE HWY
Practice Address - Street 2:SUITE 210
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7027
Practice Address - Country:US
Practice Address - Phone:410-224-2021
Practice Address - Fax:410-224-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02540103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD397SMedicare UPIN