Provider Demographics
NPI:1881858009
Name:KARA L EWING, LCSW P.L.L.C.
Entity Type:Organization
Organization Name:KARA L EWING, LCSW P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:LACEY
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-965-1218
Mailing Address - Street 1:PO BOX 481656
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5314
Mailing Address - Country:US
Mailing Address - Phone:704-965-1218
Mailing Address - Fax:
Practice Address - Street 1:1931 J N PEASE PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4544
Practice Address - Country:US
Practice Address - Phone:704-965-1218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCOO4626251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1780617902OtherNPI (USED WITH EMPLOYMENT WITH COMMUNITY MH AGENCY; APPLYING FOR PRIVATE PRACTI
NC6003517Medicaid