Provider Demographics
NPI:1356693584
Name:OWEN, JESSICA PHIPPS (MS, LCMHC, LCAS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:PHIPPS
Last Name:OWEN
Suffix:
Gender:F
Credentials:MS, LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SCUPPERNONG RD
Mailing Address - Street 2:
Mailing Address - City:MANTEO
Mailing Address - State:NC
Mailing Address - Zip Code:27954-9300
Mailing Address - Country:US
Mailing Address - Phone:336-682-1159
Mailing Address - Fax:
Practice Address - Street 1:117 SCUPPERNONG RD
Practice Address - Street 2:
Practice Address - City:MANTEO
Practice Address - State:NC
Practice Address - Zip Code:27954-9300
Practice Address - Country:US
Practice Address - Phone:336-682-1159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health