| Ewing Blue Counseling Pllc | |
|
4509 N Illinois St Ste 5 Swansea IL 62226-1524 | |
| (618) 702-9147 | |
| Not Available |
| Full Name | Ewing Blue Counseling Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4509 N Illinois St Ste 5, Swansea, Illinois |
| Authorized Official Name and Position | Felicia K Ewing (OWNER) |
| Authorized Official Contact | 6054310878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ewing Blue Counseling Pllc 4509 N Illinois St Ste 5 Swansea IL 62226-1524 Ph: (618) 702-9147 | Ewing Blue Counseling Pllc 4509 N Illinois St Ste 5 Swansea IL 62226-1524 Ph: (618) 702-9147 |
| NPI Number | 1245996198 |
|---|---|
| Provider Enumeration Date | 11/15/2021 |
| Last Update Date | 11/15/2021 |
| Certification Date | 11/15/2021 |
| Medicare PECOS PAC ID | 2567807860 |
|---|---|
| Medicare Enrollment ID | O20240227000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245996198 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Felicia K Ewing |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538630231 PECOS PAC ID: 3476998774 Enrollment ID: I20240227000190 |
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