Provider Demographics
NPI:1407022809
Name:OWENS, JEWEL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEWEL
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21956 N 71ST LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-5258
Mailing Address - Country:US
Mailing Address - Phone:623-561-5741
Mailing Address - Fax:
Practice Address - Street 1:21956 N 71ST LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-5258
Practice Address - Country:US
Practice Address - Phone:623-561-5741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-40501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical