Provider Demographics
NPI:1487987756
Name:OWEN, RITA KATHERYN (LCSW, ACSW)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:KATHERYN
Last Name:OWEN
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, ACSW
Mailing Address - Street 1:907 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-2356
Mailing Address - Country:US
Mailing Address - Phone:318-255-0615
Mailing Address - Fax:
Practice Address - Street 1:907 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2356
Practice Address - Country:US
Practice Address - Phone:318-255-0615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical