Provider Demographics
NPI:1740505411
Name:OWENS, FELICIA ANN (MFT)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:ANN
Last Name:OWENS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11675 LONE DESERT DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-5570
Mailing Address - Country:US
Mailing Address - Phone:775-686-8931
Mailing Address - Fax:
Practice Address - Street 1:11675 LONE DESERT DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-5570
Practice Address - Country:US
Practice Address - Phone:775-686-8931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVMFT#0977101YM0800X
NV0977106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV014Medicaid