Provider Demographics
NPI:1093284267
Name:OWENS, ELISSA M (LCSW)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:M
Last Name:OWENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12307-1511
Mailing Address - Country:US
Mailing Address - Phone:518-243-3300
Mailing Address - Fax:518-377-9151
Practice Address - Street 1:1023 STATE ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12307-1511
Practice Address - Country:US
Practice Address - Phone:518-243-3300
Practice Address - Fax:518-377-9151
Is Sole Proprietor?:No
Enumeration Date:2018-11-17
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0928561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical