Provider Demographics
NPI:1871252494
Name:OWENS, VARISSA (LPC)
Entity Type:Individual
Prefix:
First Name:VARISSA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5433 QUIET WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2643
Mailing Address - Country:US
Mailing Address - Phone:682-230-0278
Mailing Address - Fax:682-316-9979
Practice Address - Street 1:5433 QUIET WOODS TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-2643
Practice Address - Country:US
Practice Address - Phone:682-310-5544
Practice Address - Fax:682-316-9979
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health