Provider Demographics
NPI:1740420025
Name:OWEN, LAURIE A (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:A
Last Name:OWEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 QUEBEC ST NW
Mailing Address - Street 2:APT. 1053
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-1229
Mailing Address - Country:US
Mailing Address - Phone:202-244-0323
Mailing Address - Fax:
Practice Address - Street 1:4501 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 1011
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3710
Practice Address - Country:US
Practice Address - Phone:202-378-7589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500786761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical