Provider Demographics
NPI:1629850508
Name:EWY, MEGHANN CHRISTINE (LLC)
Entity Type:Individual
Prefix:
First Name:MEGHANN
Middle Name:CHRISTINE
Last Name:EWY
Suffix:
Gender:F
Credentials:LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 E 49TH CT N
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67220-1477
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7570 W 21ST ST N STE 1006C
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1773
Practice Address - Country:US
Practice Address - Phone:316-201-6445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC04453101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional