Provider Demographics
NPI:1013551118
Name:EWING, JULIET C (MA)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:C
Last Name:EWING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 18TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4229
Mailing Address - Country:US
Mailing Address - Phone:202-680-4768
Mailing Address - Fax:
Practice Address - Street 1:1200 G ST NW
Practice Address - Street 2:SUITE 800
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-6705
Practice Address - Country:US
Practice Address - Phone:703-552-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional