Provider Demographics
NPI:1548005952
Name:OWENS, MYAH (LCSWA)
Entity type:Individual
Prefix:
First Name:MYAH
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MINGOCREST DR
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7675
Mailing Address - Country:US
Mailing Address - Phone:919-440-0537
Mailing Address - Fax:
Practice Address - Street 1:105 MINGOCREST DR
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7675
Practice Address - Country:US
Practice Address - Phone:919-440-0537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0207311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical