Provider Demographics
NPI:1942403324
Name:OWENS, BARBARA DIANE (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:DIANE
Last Name:OWENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S CORTEZ ST STE F
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86303-7300
Mailing Address - Country:US
Mailing Address - Phone:928-445-7501
Mailing Address - Fax:928-445-7523
Practice Address - Street 1:315 S CORTEZ ST STE F
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-7300
Practice Address - Country:US
Practice Address - Phone:928-445-7501
Practice Address - Fax:928-445-7523
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSW363811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZSW36381OtherLICENSED CLINICAL SOCIAL