Provider Demographics
NPI:1023706926
Name:OWENS, AUSTIN S
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:S
Last Name:OWENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COLDSTREAM LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-7047
Mailing Address - Country:US
Mailing Address - Phone:270-385-1977
Mailing Address - Fax:
Practice Address - Street 1:203 BURKESVILLE ST STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-1900
Practice Address - Country:US
Practice Address - Phone:270-250-5070
Practice Address - Fax:270-380-1711
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty