Provider Demographics
NPI:1851261283
Name:OWENS, TIMOTHY KNOX (PHD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:KNOX
Last Name:OWENS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 SUCCESS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-5554
Mailing Address - Country:US
Mailing Address - Phone:631-559-8161
Mailing Address - Fax:
Practice Address - Street 1:818 SUCCESS AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5554
Practice Address - Country:US
Practice Address - Phone:631-559-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical