Basic Information
| Provider Information | |||||||||
| NPI: | 1730426727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OWENS | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | LCHMC, LCAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 613 1ST ST W | ||||||||
| Address2: | |||||||||
| City: | AHOSKIE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279102923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528625869 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 144B COMMUNITY COLLEGE RD | ||||||||
| Address2: | |||||||||
| City: | AHOSKIE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279108047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522098932 | ||||||||
| FaxNumber: | 2523322483 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2013 | ||||||||
| LastUpdateDate: | 02/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 3076 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | A9888 | NC | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 9888 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.