Provider Demographics
NPI:1588364731
Name:OWEN, COURTNEY STROUP (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:STROUP
Last Name:OWEN
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 MARJORIE LN
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-0258
Mailing Address - Country:US
Mailing Address - Phone:828-553-9277
Mailing Address - Fax:
Practice Address - Street 1:212 S BROAD ST STE A
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3768
Practice Address - Country:US
Practice Address - Phone:828-553-9277
Practice Address - Fax:828-475-6819
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18031101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health