Provider Demographics
NPI:1154991248
Name:PITON, EWELINA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:EWELINA
Middle Name:
Last Name:PITON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 RAYMOND DR STE 306
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9792
Mailing Address - Country:US
Mailing Address - Phone:331-732-4500
Mailing Address - Fax:331-732-4505
Practice Address - Street 1:636 RAYMOND DR STE 306
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9792
Practice Address - Country:US
Practice Address - Phone:331-732-4500
Practice Address - Fax:331-732-4505
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0185301041C0700X
IL149018530104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL33854OtherILLINOIS CERTIFICATION BOARD
IL149.018530OtherDEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION