Provider Demographics
NPI:1437765765
Name:OWENS, CHRISTINE ROSE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ROSE
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 1:104 WHISPERING PINES DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-7039
Mailing Address - Country:US
Mailing Address - Phone:502-395-1903
Mailing Address - Fax:
Practice Address - Street 1:1100 U.S. 127 SOUTH
Practice Address - Street 2:SUITE C
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4060
Practice Address - Country:US
Practice Address - Phone:502-209-7817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2551831041C0700X
KY2575891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1790731081Medicaid