Provider Demographics
NPI:1932202900
Name:OWEN, KRISTEN D (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:D
Last Name:OWEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 HIGHWAY 39 N STE A
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-1305
Mailing Address - Country:US
Mailing Address - Phone:601-531-3979
Mailing Address - Fax:601-531-3980
Practice Address - Street 1:3514 HIGHWAY 39 N STE A
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301
Practice Address - Country:US
Practice Address - Phone:601-531-3979
Practice Address - Fax:601-531-3980
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1027101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health