Provider Demographics
NPI:1679537039
Name:MCEWAN, ELIZABETH S (MSW LSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:S
Last Name:MCEWAN
Suffix:
Gender:F
Credentials:MSW LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 EAST NORTHAMPTON STREET
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-2492
Mailing Address - Country:US
Mailing Address - Phone:570-822-7118
Mailing Address - Fax:570-829-7781
Practice Address - Street 1:33 E NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-2406
Practice Address - Country:US
Practice Address - Phone:570-836-1101
Practice Address - Fax:570-836-3765
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAJW009805L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker