Healthcare Provider Details

I. General information

NPI: 1336787795
Provider Name (Legal Business Name): MARIA L OWENS BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 W IRVINE ST
RICHMOND KY
40475-1438
US

IV. Provider business mailing address

244 W IRVINE ST
RICHMOND KY
40475-1438
US

V. Phone/Fax

Practice location:
  • Phone: 502-783-7573
  • Fax: 844-822-8194
Mailing address:
  • Phone: 502-783-7573
  • Fax: 844-822-8194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number307015
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number307015
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: