Evans, Jennifer M

Evans, Jennifer M is an individual health care provider with primary practice located at 847 W Lake Dr , Mount Airy NC 27030-2157. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Evans, Jennifer M can be contacted via phone (336) 783-6919.

Contact Information

Primary practice address
847 W Lake Dr Mount Airy NC 27030-2157
Phone: (336) 783-6919
Fax: (336) 783-6923
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C008954 North Carolina

Profile Details

NPI number 1801192778
LBN Legal business name Evans, Jennifer M
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2011
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801192778 NPPES
North Carolina Other 1326440066 UNITED BEHAVIORAL HEALTH
North Carolina Other 19LHL UNITED BEHAVIORAL HEALTH
North Carolina Other 601121-053 UNITED BEHAVIORAL HEALTH
North Carolina MEDICAID 1326440066 UNITED BEHAVIORAL HEALTH
North Carolina Other 1326440066 UNITED BEHAVIORAL HEALTH
North Carolina Other Q48420A UNITED BEHAVIORAL HEALTH

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