Provider Demographics
NPI:1548993348
Name:REBECCA W EWELL LCSW PLLC
Entity type:Organization
Organization Name:REBECCA W EWELL LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:W
Authorized Official - Last Name:EWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-354-3898
Mailing Address - Street 1:5770 BLACKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:CATAWBA
Mailing Address - State:VA
Mailing Address - Zip Code:24070-2314
Mailing Address - Country:US
Mailing Address - Phone:540-354-3898
Mailing Address - Fax:
Practice Address - Street 1:811 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-5165
Practice Address - Country:US
Practice Address - Phone:540-354-3898
Practice Address - Fax:540-387-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty