Provider Demographics
NPI:1821794041
Name:MCEWEN, JON JR (ALC)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:MCEWEN
Suffix:JR
Gender:M
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-3815
Mailing Address - Country:US
Mailing Address - Phone:256-391-6835
Mailing Address - Fax:
Practice Address - Street 1:318 N COLLEGE ST STE E
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-3815
Practice Address - Country:US
Practice Address - Phone:334-363-2178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC03875101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health