Provider Demographics
NPI:1669651709
Name:OWEN, LYN R (LPC, MHSP)
Entity Type:Individual
Prefix:
First Name:LYN
Middle Name:R
Last Name:OWEN
Suffix:
Gender:F
Credentials:LPC, MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 LEE HWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2452
Mailing Address - Country:US
Mailing Address - Phone:423-855-0402
Mailing Address - Fax:423-370-1518
Practice Address - Street 1:6400 LEE HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2452
Practice Address - Country:US
Practice Address - Phone:423-855-0402
Practice Address - Fax:423-370-1518
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health