Provider Demographics
NPI:1740675784
Name:EWING, CHELSEA (MS, LMFT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:EWING
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5743 CORSA AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4027
Mailing Address - Country:US
Mailing Address - Phone:818-570-0714
Mailing Address - Fax:
Practice Address - Street 1:5743 CORSA AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4027
Practice Address - Country:US
Practice Address - Phone:818-570-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86037106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist