Provider Demographics
NPI:1508562992
Name:OWENS, COURTNEY DIANNE (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:DIANNE
Last Name:OWENS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:DIANNE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:523 SPRING FOREST RD APT A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7232
Mailing Address - Country:US
Mailing Address - Phone:252-347-6856
Mailing Address - Fax:
Practice Address - Street 1:523 SPRING FOREST RD APT A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7232
Practice Address - Country:US
Practice Address - Phone:252-347-6856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0150681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical