Provider Demographics
NPI:1689201253
Name:OWEN COUNSELING AND CONSULTING, PLLC
Entity Type:Organization
Organization Name:OWEN COUNSELING AND CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LAC
Authorized Official - Phone:701-659-0490
Mailing Address - Street 1:7795 SAINT GERTRUDE AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:ND
Mailing Address - Zip Code:58564-4103
Mailing Address - Country:US
Mailing Address - Phone:701-659-0490
Mailing Address - Fax:
Practice Address - Street 1:3111 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-5085
Practice Address - Country:US
Practice Address - Phone:701-659-0490
Practice Address - Fax:701-713-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health