Provider Demographics
NPI:1174259014
Name:OWENS, MARENA (LSW)
Entity Type:Individual
Prefix:
First Name:MARENA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 WOODLAND ST NE UNIT A
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-5348
Mailing Address - Country:US
Mailing Address - Phone:330-469-6777
Mailing Address - Fax:330-469-6779
Practice Address - Street 1:1705 WOODLAND ST NE UNIT A
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-5348
Practice Address - Country:US
Practice Address - Phone:330-469-6777
Practice Address - Fax:330-469-6779
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health