Healthcare Provider Details

I. General information

NPI: 1376452151
Provider Name (Legal Business Name): APRIL TAMIKA OWENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 COUNTRY CLUB DR
STOCKBRIDGE GA
30281-7349
US

IV. Provider business mailing address

1132 ALASKA ST
HAMPTON GA
30228-3802
US

V. Phone/Fax

Practice location:
  • Phone: 770-474-8400
  • Fax: 770-474-3738
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC010423
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: