Provider Demographics
NPI:1104218734
Name:CHUCK OWINGS MSW, LCSW LLC
Entity Type:Organization
Organization Name:CHUCK OWINGS MSW, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:OWINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:417-667-6380
Mailing Address - Street 1:900 W PITCHER ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3041
Mailing Address - Country:US
Mailing Address - Phone:417-667-6380
Mailing Address - Fax:417-667-7607
Practice Address - Street 1:300 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-2202
Practice Address - Country:US
Practice Address - Phone:417-667-4230
Practice Address - Fax:417-667-7607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011010985251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health