Provider Demographics
NPI:1417496365
Name:EWING, TAMIKA (LPC-S)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:
Last Name:EWING
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 S DAIRY ASHFORD RD STE 415
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-4860
Mailing Address - Country:US
Mailing Address - Phone:281-763-1519
Mailing Address - Fax:855-763-4502
Practice Address - Street 1:1880 S DAIRY ASHFORD RD STE 415
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4860
Practice Address - Country:US
Practice Address - Phone:281-763-1519
Practice Address - Fax:855-763-4502
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69223101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health