=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891845269
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHASE MCEWEN LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2007
-----------------------------------------------------
Last Update Date | 05/12/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5327 COMMERCIAL WAY C115
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-597-5497
-----------------------------------------------------
Fax | 352-597-1662
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5327 COMMERCIAL WAY C115
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-597-5497
-----------------------------------------------------
Fax | 352-597-1662
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | SW1927
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SW1927
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------