MEDICARE: JAVEN OWENS LPC

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
1	101YP2500X	Professional Counselor	83878	TX

General Provider Information

NPI Number	:	1972847911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAVEN OWENS LPC

Provider Business Mailing Address
First Line	:	385 CALLE DE ALEGRA STE A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3423
Country	:	US
Telephone Number	:	575-526-1105
Fax Number	:	575-524-4266

Provider Business Practice Location Address
First Line	:	5703 WELSCH VW
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-3149
Country	:	US
Telephone Number	:	210-540-5033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	12/02/2022

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Directions to “ JAVEN OWENS LPC” Practice Location

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