Provider Demographics
NPI:1629856562
Name:OWENS, MICHELE (LMFT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 WAYZATA BLVD STE 710
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1733
Mailing Address - Country:US
Mailing Address - Phone:612-735-8002
Mailing Address - Fax:
Practice Address - Street 1:6465 WAYZATA BLVD STE 710
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-1733
Practice Address - Country:US
Practice Address - Phone:612-735-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2684101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health