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NPI Code Detail

MEDICARE: FELICIA K EWING LCPC

MEDICARE:   FELICIA K EWING  LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor180.013516IL
2101YP2500XProfessional Counselor180.013516IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538630231
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELICIA K EWING LCPC
Provider Business Mailing Address
First Line : 4509 N ILLINOIS ST STE 2
Second Line :
City : SWANSEA
State : IL
Zip : 62226-1524
Country : US
Telephone Number : 618-702-9147
Fax Number : 618-591-2952
Provider Business Practice Location Address
First Line : 4509 N ILLINOIS ST STE 2
Second Line :
City : SWANSEA
State : IL
Zip : 62226-1524
Country : US
Telephone Number : 618-702-9147
Fax Number : 618-591-2952
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2018
Last Update Date : 06/16/2026

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