Healthcare Provider Details

I. General information

NPI: 1639265879
Provider Name (Legal Business Name): SUZANNE JONES EWING BS MS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S PEORIA AVE
TULSA OK
74120-4429
US

IV. Provider business mailing address

650 S PEORIA
TULSA OK
74120-4429
US

V. Phone/Fax

Practice location:
  • Phone: 918-587-9471
  • Fax: 918-560-0137
Mailing address:
  • Phone: 918-587-9471
  • Fax: 918-560-0137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW297
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT613
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: