Provider Demographics
NPI:1952373359
Name:OWENS, MARIA (LISW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30400 DETROIT #301
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-4444
Mailing Address - Country:US
Mailing Address - Phone:216-926-1369
Mailing Address - Fax:
Practice Address - Street 1:20325 CENTER RIDGE RD STE 612
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3554
Practice Address - Country:US
Practice Address - Phone:216-926-1369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0009664-SUPV1041C0700X
OHI-00096641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical