Provider Demographics
NPI:1528041555
Name:OWENS, REBECCA LYNNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNNE
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 1:2323 OASIS DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-5056
Mailing Address - Country:US
Mailing Address - Phone:910-520-4904
Mailing Address - Fax:
Practice Address - Street 1:2323 OASIS DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-5056
Practice Address - Country:US
Practice Address - Phone:910-520-4904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0045191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
7410644OtherAETNA
NC19PL9OtherBCBS
7410644OtherAETNA
7410644OtherAETNA