Amy Owen

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.011741 Issued in IL

Practice address

636 Church St
Evanston, IL 60201-4508

Phone

(203) 693-4917

NPI assigned

Dec 19, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Amy Owen Counseling LLC

  • Professional Counselor
  • Evanston, IL
  • NPI 1891357356
  NPD Authorized official
• Amy Owen Counseling PLLC

  • Professional Counselor
  • New Haven, CT
  • NPI 1760952550
  NPD
• Amy Albero LLC

  dba Revive Center For Wellness

  • Clinical Social Worker
  • Stamford, CT
  • NPI 1992230288

  Single Specialty

  NPD (past)
• Tabitha B. Fortt, M.D., LLC

  • Primary Care Clinic/Center
  • Stamford, CT
  • NPI 1235597741

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1033625603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014508",
            "telephone_number": "203-693-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014508",
            "telephone_number": "203-693-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia C. Otis, APN-CNP
• Therese Otoole, LICSW
• Our Reality PLLC
• Outside the Pill Box LTD (Outside The Pill Box)
• David Wei Ouyang, MD
• Daleisha Owolide, DALEISHA OWOLIDE
• Matthew S Pablo, APN-CRNA
• Daria A Pachovsky, MD
• James L Padgett, M.D.
• Jason H. Paek, DO

• Professional Counselor in Evanston, IL
• Providers in Evanston, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.