Provider Demographics
NPI:1407587918
Name:OWENS, SONJA (LGPC)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 CHURCH LN APT J
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-5201
Mailing Address - Country:US
Mailing Address - Phone:443-943-6761
Mailing Address - Fax:
Practice Address - Street 1:1000 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-1317
Practice Address - Country:US
Practice Address - Phone:443-551-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12709101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health