Provider Demographics
NPI:1407221161
Name:OWEN, LONNIE
Entity type:Individual
Prefix:
First Name:LONNIE
Middle Name:
Last Name:OWEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 LYNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2250
Mailing Address - Country:US
Mailing Address - Phone:614-306-4718
Mailing Address - Fax:
Practice Address - Street 1:14930 MUESCHKE RD STE 100
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-0980
Practice Address - Country:US
Practice Address - Phone:346-206-3992
Practice Address - Fax:832-652-3626
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67783101YP2500X
TX11475101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)