MEDICARE: MRS. KARA L 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	C004626	NC

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	:	1780617902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARA L EWING LCSW

Provider Business Mailing Address
First Line	:	15602 GATHERING OAKS DR
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-5673
Country	:	US
Telephone Number	:	704-235-1776
Fax Number	:

Provider Business Practice Location Address
First Line	:	18121 W CATAWBA AVE
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-5641
Country	:	US
Telephone Number	:	704-235-1776
Fax Number	:

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	04/22/2020

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