Provider Demographics
NPI:1770566887
Name:EWING, LINDA JEANNE (PHD, RN)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JEANNE
Last Name:EWING
Suffix:
Gender:F
Credentials:PHD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 N CRAIG ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1571
Mailing Address - Country:US
Mailing Address - Phone:412-683-0215
Mailing Address - Fax:412-683-0642
Practice Address - Street 1:155 N CRAIG ST
Practice Address - Street 2:SUITE 120
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1571
Practice Address - Country:US
Practice Address - Phone:412-683-0215
Practice Address - Fax:412-683-0642
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007400L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1526519Medicare ID - Type Unspecified
PAR83498Medicare UPIN