Keith K. Ewell, PH.D.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

0810002479 Issued in VA

Legal business name

KEITH K. EWELL, PH.D.

Practice address

12700 Sabastian Dr
Fairfax, VA 22030-6610

Phone

(703) 322-0701

NPI assigned

Oct 6, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Keith K. Ewell, PH.D.

Title

Licensed Clinical Psychologist

Phone

(703) 322-0701

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1265835219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SABASTIAN DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306610",
            "telephone_number": "703-322-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SABASTIAN DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306610",
            "telephone_number": "703-322-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH K. EWELL, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "EWELL",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "703-322-0701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "VA",
            "license": "0810002479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kazumi Keener, OT
• Samantha Anne Kehn
• Daniel Edward Keim, M.D.
• Kathryn Gray Keiser, M.S.
• Keith J Wilson DDS PC
• Courtney Ann Kelchlin, PHARMD
• Joan Kelleher
• Barbara B Keller, PH.D.
• Kaitlyn Rae Kellermeyer
• Jenna Kelley, MS, LPC, ATR

• Adolescent and Children Mental Health Clinic/Center in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Adolescent and Children Mental Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; 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.