Provider Demographics
NPI:1548921620
Name:OWENS, MARIA (LSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 SEAMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-3508
Mailing Address - Country:US
Mailing Address - Phone:908-421-1323
Mailing Address - Fax:
Practice Address - Street 1:834 SEAMAN AVE
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-3508
Practice Address - Country:US
Practice Address - Phone:908-421-1323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-01
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC062764001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7770000626530804Medicaid