Provider Demographics
NPI:1497091540
Name:OWEN, ANNE CONNIE (MA, MLADC, LCS)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:CONNIE
Last Name:OWEN
Suffix:
Gender:F
Credentials:MA, MLADC, LCS
Other - Prefix:MS
Other - First Name:CONNIE
Other - Middle Name:ANNE
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MLADC, LCS
Mailing Address - Street 1:99 HANOVER ST.
Mailing Address - Street 2:CFS ASAT
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03105
Mailing Address - Country:US
Mailing Address - Phone:603-518-4000
Mailing Address - Fax:603-668-6260
Practice Address - Street 1:99 HANOVER ST.
Practice Address - Street 2:CFS ASAT
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03105
Practice Address - Country:US
Practice Address - Phone:603-518-4000
Practice Address - Fax:603-668-6260
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0021101YA0400X
NH0413103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)