Provider Demographics
NPI:1043469109
Name:OWENS, AMY M (LMHC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:OWENS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:AMELIA
Other - Middle Name:G
Other - Last Name:MARKS OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA COUNSELING
Mailing Address - Street 1:8102 CLEARVISTA PKWY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1661
Mailing Address - Country:US
Mailing Address - Phone:317-849-8222
Mailing Address - Fax:317-849-1455
Practice Address - Street 1:8102 CLEARVISTA PKWY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1661
Practice Address - Country:US
Practice Address - Phone:317-849-8222
Practice Address - Fax:317-849-1455
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 106H00000X
IN39000237A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist