Provider Demographics
NPI:1043575012
Name:OWENS, BRYANA ADDISON (LCSW, ACHP-SW)
Entity Type:Individual
Prefix:
First Name:BRYANA
Middle Name:ADDISON
Last Name:OWENS
Suffix:
Gender:F
Credentials:LCSW, ACHP-SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1741
Mailing Address - Country:US
Mailing Address - Phone:720-297-6479
Mailing Address - Fax:
Practice Address - Street 1:1540 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1741
Practice Address - Country:US
Practice Address - Phone:720-297-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
COCSW-16081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional