Provider Demographics
NPI:1376379966
Name:OWENS, NICHOLAS (LPC-MHSP)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:OWENS
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 VILLAGE CREST WAY APT 233
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-5026
Mailing Address - Country:US
Mailing Address - Phone:706-244-7162
Mailing Address - Fax:
Practice Address - Street 1:408 N CEDAR BLUFF RD STE 300
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-3611
Practice Address - Country:US
Practice Address - Phone:865-637-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional