Provider Demographics
NPI:1083042303
Name:OWENS, TIMOTHY NEWTON (LCSW)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:NEWTON
Last Name:OWENS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 N DEQUINCY ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201-3706
Mailing Address - Country:US
Mailing Address - Phone:317-506-4097
Mailing Address - Fax:
Practice Address - Street 1:7830 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2075
Practice Address - Country:US
Practice Address - Phone:317-396-0683
Practice Address - Fax:317-396-0687
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006757A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical