Healthcare Provider Details

I. General information

NPI: 1003671645
Provider Name (Legal Business Name): AMBER RAE OWENS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 HUNT CLUB BLVD STE 8
GALLATIN TN
37066-6095
US

IV. Provider business mailing address

1003 PITTMAN DR
GALLATIN TN
37066-8461
US

V. Phone/Fax

Practice location:
  • Phone: 615-852-8282
  • Fax:
Mailing address:
  • Phone: 931-220-2915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12300
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10341
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: