Provider Demographics
NPI:1881847085
Name:EWING, KATHERINE LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:LOUISE
Last Name:EWING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:4860 ROBB ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2162
Mailing Address - Country:US
Mailing Address - Phone:303-278-7418
Mailing Address - Fax:888-341-5050
Practice Address - Street 1:2101 MANITOBA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3375
Practice Address - Country:US
Practice Address - Phone:719-328-2518
Practice Address - Fax:719-630-0171
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO10461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13577972OtherCAQH