Provider Demographics
NPI:1922179977
Name:EWING, JOHN W (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:W
Last Name:EWING
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5219 E. 200 SOUTH CO. ROAD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123
Mailing Address - Country:US
Mailing Address - Phone:317-838-9777
Mailing Address - Fax:317-838-9777
Practice Address - Street 1:5610 CRAWFORDSVILLE RD
Practice Address - Street 2:SUITE 22
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-3727
Practice Address - Country:US
Practice Address - Phone:317-244-2243
Practice Address - Fax:317-243-2328
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000584A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical