Provider Demographics
NPI:1033627534
Name:ALLIE, OWEN JULIEN (LPC, CSAC, NCC)
Entity Type:Individual
Prefix:MR
First Name:OWEN
Middle Name:JULIEN
Last Name:ALLIE
Suffix:
Gender:M
Credentials:LPC, CSAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3103
Mailing Address - Country:US
Mailing Address - Phone:518-257-6881
Mailing Address - Fax:
Practice Address - Street 1:60 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3103
Practice Address - Country:US
Practice Address - Phone:518-257-6881
Practice Address - Fax:703-779-8628
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-18
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008995101YM0800X
VA0701007453101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty