Provider Demographics
NPI:1639470669
Name:OWEN, MICHELLE (NCC, LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WOODED RUN DR
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-9113
Mailing Address - Country:US
Mailing Address - Phone:717-254-7444
Mailing Address - Fax:
Practice Address - Street 1:5351C JAYCEE AVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2997
Practice Address - Country:US
Practice Address - Phone:717-657-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005659101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional