Healthcare Provider Details

I. General information

NPI: 1194483834
Provider Name (Legal Business Name): DEBBIE OWEN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 WILLIAM ST SUITE 1
LYONS NY
14489
US

IV. Provider business mailing address

58 WILLIAM ST SUITE 1
LYONS NY
14489
US

V. Phone/Fax

Practice location:
  • Phone: 315-665-2025
  • Fax:
Mailing address:
  • Phone: 315-665-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number011859
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: