Provider Demographics
NPI:1154068872
Name:OWENS, LINDA ANNETTE (LMSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNETTE
Last Name:OWENS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 PENNSYLVANIA AVE UNIT 2012646
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-1856
Mailing Address - Country:US
Mailing Address - Phone:144-344-7463
Mailing Address - Fax:
Practice Address - Street 1:2646 PENNSYLVANIA AVE UNIT 2012646
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-1856
Practice Address - Country:US
Practice Address - Phone:144-344-7463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-14
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21477104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker