Healthcare Provider Details

I. General information

NPI: 1881249001
Provider Name (Legal Business Name): BROOKE S OWENS LCSW, LCAS, CCSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2019
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4819 EMPEROR BLVD STE 400
DURHAM NC
27703-5420
US

IV. Provider business mailing address

4819 EMPEROR BLVD STE 400
DURHAM NC
27703-5420
US

V. Phone/Fax

Practice location:
  • Phone: 984-310-2151
  • Fax:
Mailing address:
  • Phone: 984-310-2151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC017259
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: