Provider Demographics
NPI:1689240814
Name:OWENS, NATALIA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 OAK RIDGE CT STE 404
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9369
Mailing Address - Country:US
Mailing Address - Phone:239-963-4367
Mailing Address - Fax:
Practice Address - Street 1:2734 OAK RIDGE CT STE 404
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9369
Practice Address - Country:US
Practice Address - Phone:239-963-4367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23152101YM0800X
VA0701013263101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health