Healthcare Provider Details

I. General information

NPI: 1669873485
Provider Name (Legal Business Name): MORGANNE OWENS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 09/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44095 PIPELINE PLZ SUITE 240
ASHBURN VA
20147-5898
US

IV. Provider business mailing address

44095 PIPELINE PLZ SUITE 240
ASHBURN VA
20147-5898
US

V. Phone/Fax

Practice location:
  • Phone: 703-723-2999
  • Fax:
Mailing address:
  • Phone: 703-723-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904008252
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017056
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: