Jesse Lee Owens, M.A, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-007440 Issued in IL

Practice address

15475 S Park Ave Ste 102
South Holland, IL 60473-1378

Phone

(312) 480-5775

Fax

(312) 436-5208

NPI assigned

Aug 30, 2005

Last updated

Oct 10, 2017By the provider in NPPES

Sex

Male

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 2

Other names 1

• Mr. Jesse Lee Owens Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Consulting Professionals Inc

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  • NPI 1104926625
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1871586214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604250084",
            "telephone_number": "773-759-2109",
            "fax_number": "773-238-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15475 S PARK AVE STE 102",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731378",
            "telephone_number": "312-480-5775",
            "fax_number": "312-436-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "JESSE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "M.A, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-007440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "01634638",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALTH",
            "identifier": "810323000",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "OWENS",
            "middle_name": "LEE",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Optimum Health Chiropractic & Wellness Center, Inc.
• Opulent Luxury Laboratory (Opulent Lux Lab LLC.)
• Wojciech Ornowski, MD
• Praveen Parvathala, M.D.
• Dharmesh Kanubhai Patel, M.D.
• Dipeeka Patel, N.P.,
• Divya Patel, OD
• Jasmin Patel, PA-C

• Clinical Social Worker in South Holland, IL
• Providers in South Holland, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.