Provider Demographics
NPI:1013177351
Name:OWEN, RICKY B (LMFT)
Entity Type:Individual
Prefix:DR
First Name:RICKY
Middle Name:B
Last Name:OWEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 SCATTERED OAKS TRL
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-4374
Mailing Address - Country:US
Mailing Address - Phone:214-458-0646
Mailing Address - Fax:972-552-2233
Practice Address - Street 1:205 E US HIGHWAY 80
Practice Address - Street 2:SUITE 110
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-8604
Practice Address - Country:US
Practice Address - Phone:214-458-0646
Practice Address - Fax:972-552-2233
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200957106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist