Provider Demographics
NPI:1306009063
Name:OWENS, CHIKEITHA L (MA, LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:CHIKEITHA
Middle Name:L
Last Name:OWENS
Suffix:
Gender:F
Credentials:MA, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 NORTHWEST HWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5894
Mailing Address - Country:US
Mailing Address - Phone:214-783-0758
Mailing Address - Fax:214-501-3494
Practice Address - Street 1:1301 NORTHWEST HWY
Practice Address - Street 2:SUITE 209
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5894
Practice Address - Country:US
Practice Address - Phone:214-783-0758
Practice Address - Fax:214-501-3494
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63838101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2055071-01Medicaid