Provider Demographics
NPI:1790732006
Name:EWELL, JOYCE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:
Last Name:EWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 JASMINE LN
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-4067
Mailing Address - Country:US
Mailing Address - Phone:843-813-8960
Mailing Address - Fax:
Practice Address - Street 1:105 CENTRAL AVE
Practice Address - Street 2:SUITE 300 A
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-3084
Practice Address - Country:US
Practice Address - Phone:843-813-8960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health