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NPI Code Detail

MEDICARE: MRS. SUZANNA VICTORIA OWENS LPC/MHSP/NCC

MEDICARE:  MRS. SUZANNA VICTORIA OWENS  LPC/MHSP/NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4550TN

General Provider Information

NPI Number : 1437615507
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUZANNA VICTORIA OWENS LPC/MHSP/NCC
Provider Business Mailing Address
First Line : 2673 YALE AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38112-3335
Country : US
Telephone Number : 901-567-0415
Fax Number :
Provider Business Practice Location Address
First Line : 6551 STAGE OAKS DR STE 4
Second Line :
City : BARTLETT
State : TN
Zip : 38134-3895
Country : US
Telephone Number : 901-387-0026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2019
Last Update Date : 02/22/2024

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Directions to “ MRS. SUZANNA VICTORIA OWENS LPC/MHSP/NCC” Practice Location

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