Provider Demographics
NPI:1902934441
Name:EWER, CAROL JOYCE (MHR LPC LADC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JOYCE
Last Name:EWER
Suffix:
Gender:F
Credentials:MHR LPC LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14101 FONTELLA LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-9329
Mailing Address - Country:US
Mailing Address - Phone:405-330-2776
Mailing Address - Fax:
Practice Address - Street 1:616 NW 21ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1810
Practice Address - Country:US
Practice Address - Phone:405-528-7721
Practice Address - Fax:405-528-7731
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK485101YA0400X
OK2485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health