Provider Demographics
NPI:1720760192
Name:MCEWAN, KATE
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:MCEWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6710 BURLINGTON AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-7622
Mailing Address - Country:US
Mailing Address - Phone:772-486-4017
Mailing Address - Fax:
Practice Address - Street 1:5536 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1717
Practice Address - Country:US
Practice Address - Phone:727-565-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health