Provider Demographics
NPI:1497543284
Name:MCEWEN, MARVIN TORRELL
Entity type:Individual
Prefix:
First Name:MARVIN
Middle Name:TORRELL
Last Name:MCEWEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 EMILINE PLZ APT D205
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-7091
Mailing Address - Country:US
Mailing Address - Phone:402-769-5071
Mailing Address - Fax:
Practice Address - Street 1:9850 EMILINE PLZ APT D205
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-7091
Practice Address - Country:US
Practice Address - Phone:402-769-5071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities