Provider Demographics
NPI:1144089665
Name:EWING, LATOYA LOUISE (MSW, LSW)
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:LOUISE
Last Name:EWING
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 AVENUE B
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2202
Mailing Address - Country:US
Mailing Address - Phone:201-469-5042
Mailing Address - Fax:
Practice Address - Street 1:285 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-3005
Practice Address - Country:US
Practice Address - Phone:908-707-0212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06327300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker