MEDICARE: MS. VICTORIA LYNN EWING LCSW

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
1	1041C0700X	Clinical Social Worker	3137	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1659420768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA LYNN EWING LCSW

Provider Business Mailing Address
First Line	:	5552 BIG PERRY RD
Second Line	:
City	:	MOREHEAD
State	:	KY
Zip	:	40351-8954
Country	:	US
Telephone Number	:	859-312-7229
Fax Number	:	859-309-0353

Provider Business Practice Location Address
First Line	:	5552 BIG PERRY RD
Second Line	:
City	:	MOREHEAD
State	:	KY
Zip	:	40351-8954
Country	:	US
Telephone Number	:	859-312-7229
Fax Number	:	859-309-0353

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	08/28/2023

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