Provider Demographics
NPI:1114059714
Name:EWING, THOMAS H (MA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:EWING
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 F ST
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-2607
Mailing Address - Country:US
Mailing Address - Phone:719-221-2502
Mailing Address - Fax:719-221-2502
Practice Address - Street 1:448 E 1ST ST
Practice Address - Street 2:SUITE 226
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2804
Practice Address - Country:US
Practice Address - Phone:719-207-4163
Practice Address - Fax:719-745-7000
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor