Provider Demographics
NPI:1912216318
Name:OWENS, MICHAEL CARMON (MA, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CARMON
Last Name:OWENS
Suffix:
Gender:M
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 REGENCY SQUARE BLVD STE 136
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3181
Mailing Address - Country:US
Mailing Address - Phone:713-780-2833
Mailing Address - Fax:
Practice Address - Street 1:7100 REGENCY SQUARE BLVD STE 136
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3181
Practice Address - Country:US
Practice Address - Phone:713-780-2833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-02
Last Update Date:2010-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16147101YM0800X
TX4910106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health