Eric William Ewell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS19702 Issued in CA

Practice address

6724 Coleen LN
San Bernardino, CA 92407-1916

Phone

(909) 754-7789

NPI assigned

Nov 8, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1104170364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90364",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924271364",
            "telephone_number": "909-754-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6724 COLEEN LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924071916",
            "telephone_number": "909-754-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWELL",
        "first_name": "ERIC",
        "middle_name": "WILLIAM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS19702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• R. Marlene Evans
• Charles J Evelyn
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• Caroline Mallika Ewan
• Clerisse Ann Ewelike, NP-C
• Nicole Agostino Ewens, M.S. PA-C
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• F&M Radiology Medical Center Inc

• All providers in San Bernardino, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.