Lawrence Donald Ewert, HSPP
Individual provider Active NPI Clinical Psychologist · Columbus, IN
NPI 1326010703 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1326010703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 20010172A (IN)
- Practice address
- 806 Jackson St
Columbus, IN 47201-6264 - Phone
- (812) 379-4033
- Fax
- (812) 378-8367
- NPI assigned
- Feb 1, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20010172A | IN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20010172A | IN | Yes |
Addresses
Primary practice location
806 Jackson St
Columbus, IN 47201-6264
Mailing address
720 N Marr Rd
Columbus, IN 47201-6660
Phone (812) 314-3500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000209012 | Other | IN | ANTHEM PIN |
Other providers in Columbus, IN
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- Alexis Everitt
- Jennifer Everroad
- Everside Health at Enkei
- Everside Health at NTN Columbus W Goeller
- Michelle Ann Ewing
- Victoria Ewing
- Eyemart Express LLC
- Kelly Falter
- Families for Peace Inc
All providers in Columbus, IN · Clinical Psychologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.