Provider Demographics
NPI:1477180628
Name:OWUSU, STEPHEN (MA, BA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:OWUSU
Suffix:
Gender:M
Credentials:MA, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 WESTMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-4766
Mailing Address - Country:US
Mailing Address - Phone:978-345-0685
Mailing Address - Fax:978-829-2210
Practice Address - Street 1:545 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-4766
Practice Address - Country:US
Practice Address - Phone:978-345-0685
Practice Address - Fax:978-829-2210
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor