Provider Demographics
NPI:1811431687
Name:OWEN, KEVON (LPC)
Entity type:Individual
Prefix:DR
First Name:KEVON
Middle Name:
Last Name:OWEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12901 E BRITTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:JONES
Mailing Address - State:OK
Mailing Address - Zip Code:73049-7407
Mailing Address - Country:US
Mailing Address - Phone:405-740-1249
Mailing Address - Fax:
Practice Address - Street 1:12901 E BRITTON RD STE B
Practice Address - Street 2:
Practice Address - City:JONES
Practice Address - State:OK
Practice Address - Zip Code:73049-7407
Practice Address - Country:US
Practice Address - Phone:405-740-1249
Practice Address - Fax:405-399-2471
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6714101YM0800X
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health