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General NPI Number Information
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NPI Number | 1497644884
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Entity Type | Individual
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Provider Name | STACEY OWENS LPC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 245 HAIRSTON ST
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City | DANVILLE
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State | VA
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Zip | 24540-4137
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Country | US
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Telephone | 434-793-4922
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Fax |
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Provider Business Mailing Address
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Address Line | 3124 RAMBLE RD
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City | VIRGILINA
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State | VA
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Zip | 24598-3138
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Country | US
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Telephone | 434-222-8569
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701015028
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License Number State | VA
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