Provider Demographics
NPI:1609822832
Name:OWENS, ELBERT CHARLES (LPC)
Entity Type:Individual
Prefix:MR
First Name:ELBERT
Middle Name:CHARLES
Last Name:OWENS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 GUM BRANCH RD STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-6269
Mailing Address - Country:US
Mailing Address - Phone:910-353-8255
Mailing Address - Fax:910-355-2427
Practice Address - Street 1:824 GUM BRANCH RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-6269
Practice Address - Country:US
Practice Address - Phone:910-353-8255
Practice Address - Fax:910-355-2427
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4601101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health