Provider Demographics
NPI:1437493178
Name:OWES, BARON KEITH (CRC)
Entity Type:Individual
Prefix:
First Name:BARON
Middle Name:KEITH
Last Name:OWES
Suffix:
Gender:M
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 BROAD ST APT 104
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4057
Mailing Address - Country:US
Mailing Address - Phone:133-465-7197
Mailing Address - Fax:
Practice Address - Street 1:6201 BROAD ST APT 104
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4057
Practice Address - Country:US
Practice Address - Phone:133-465-7197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL00085651101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor