Provider Demographics
NPI:1750418869
Name:MCEWEN, JAMES H (LMFT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:MCEWEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E ANGELENO AVE UNIT 325
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2954
Mailing Address - Country:US
Mailing Address - Phone:323-485-0193
Mailing Address - Fax:323-463-0619
Practice Address - Street 1:550 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1912
Practice Address - Country:US
Practice Address - Phone:323-769-7129
Practice Address - Fax:323-463-0619
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45637106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHGH4484Medicare ID - Type Unspecified