Provider Demographics
NPI:1336530716
Name:OWENS, BETHANY (LSCSW)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8100 E 22ND ST N STE 1600-B
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2321
Mailing Address - Country:US
Mailing Address - Phone:316-201-6424
Mailing Address - Fax:316-284-6491
Practice Address - Street 1:8100 E 22ND ST N STE 1600-B
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2321
Practice Address - Country:US
Practice Address - Phone:316-201-6424
Practice Address - Fax:316-284-6491
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-06
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8073104100000X
KS47681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical