Brenda L Owen, LAC, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4755 Issued in ND

Practice address

1500 14TH St W Ste 290
Williston, ND 58801-4078

Phone

(701) 334-6242

Fax

(701) 713-3299

NPI assigned

Nov 17, 2010

Last updated

Feb 27, 2018By the provider in NPPES

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

Other identifiers 1

Other names 1

• Brenda L Owen Other name

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of North Dakota School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Counseling IncGroup PAC ID 1153603162, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Williston, ND
  • NPI 1427593698

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD Authorized official
• Summit Counseling Services

  • Community/Behavioral Health Agency
  • Williston, ND
  • NPI 1235593708
  Authorized official Same address or phone

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1346542727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 14TH ST W STE 290",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588014078",
            "telephone_number": "701-334-6242",
            "fax_number": "701-713-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 14TH ST W STE 290",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588014078",
            "telephone_number": "701-334-6242",
            "fax_number": "701-713-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 4th St NW Ste 5",
            "address_purpose": "LOCATION",
            "city": "Devils Lake",
            "state": "ND",
            "postal_code": "583012960",
            "country_code": "US",
            "telephone_number": "701-662-6776",
            "fax_number": "701-662-6889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "BRENDA",
        "middle_name": "L",
        "credential": "LAC, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1613",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "4755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454696",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "OWEN",
            "middle_name": "L",
            "credential": "LAC, LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Lara R Packard, BSN
• Jeong Eun Park
• Pathology Services

• Clinical Social Worker in Williston, ND
• Providers in Williston, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.