Provider Demographics
NPI:1346780970
Name:OWENS, ROBERT L (LPCC-S)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:OWENS
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 READING RD STE A
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2654
Mailing Address - Country:US
Mailing Address - Phone:513-259-8050
Mailing Address - Fax:513-770-9892
Practice Address - Street 1:969 READING RD STE A
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2654
Practice Address - Country:US
Practice Address - Phone:513-445-9688
Practice Address - Fax:513-770-9892
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1500555101Y00000X
OHE.1901120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0360608Medicaid