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General NPI Number Information
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NPI Number | 1922982230
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Entity Type | Individual
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Provider Name | DAVID SHANE EWING MSW, LGSW
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Gender | Male
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 6375 W 143RD ST
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City | SAVAGE
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State | MN
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Zip | 55378-2888
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Country | US
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Telephone | 952-592-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 1707 RIVERSIDE DR
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City | SHAKOPEE
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State | MN
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Zip | 55379-0080
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Country | US
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Telephone | 517-673-3413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 35057
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License Number State | MN
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