Moriah Ewing

Primary specialty

Social WorkerTaxonomy code 104100000X

License

13554 Issued in WI

Practice address

605 4TH St S
La Crosse, WI 54601-4458

Phone

(608) 615-1023

Fax

(608) 615-1063

NPI assigned

May 23, 2023

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brave Spaces Counseling and Wellness, LLC

  • Community/Behavioral Health Agency
  • La Crosse, WI
  • NPI 1811580574
  NPD

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1851083398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 4TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014458",
            "telephone_number": "608-615-1023",
            "fax_number": "608-615-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 4TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014458",
            "telephone_number": "608-615-1023",
            "fax_number": "608-615-1063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 W Franklin St",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "WI",
            "postal_code": "546561754",
            "country_code": "US",
            "telephone_number": "608-615-1023",
            "fax_number": "608-615-1063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EWING",
        "first_name": "MORIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "13554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan R Everett, PSYD
• Pamela Ann Evers, ADN
• Reid Evers, DDS
• Arlyce O Everson, RN, CCM, NCTMB
• Evolve Mental Health Solutions, LLC
• Eyemart Express, LTD.
• Kennedy Fabian, COTA/L
• Leah N Fagan
• Debra J Fahey, APNP
• Madelyn Rose Fahhoum, MD

• Social Worker in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.