Healthcare Provider Details

I. General information

NPI: 1508562992
Provider Name (Legal Business Name): COURTNEY DIANNE OWENS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: COURTNEY DIANNE WILLIAMS LCSW

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 S MIAMI BLVD STE 123
DURHAM NC
27703-5797
US

IV. Provider business mailing address

2304 S MIAMI BLVD STE 123
DURHAM NC
27703-5797
US

V. Phone/Fax

Practice location:
  • Phone: 984-275-9818
  • Fax:
Mailing address:
  • Phone: 984-275-9818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP015068
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: