Evans, Robert L

Evans, Robert L is an sole proprietor health care provider with primary practice located at 3200 Crain Hwy Ste 205 , Waldorf MD 20603-4843. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Evans, Robert L can be contacted via phone (240) 448-2475.

Contact Information

Primary practice address
3200 Crain Hwy Ste 205 Waldorf MD 20603-4843
Phone: (240) 448-2475
Fax: (240) 448-2335
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X PRC14040 District of Columbia
Behavioral Health & Social Service Providers / Professional 101YP2500X LC3102 Maryland

Profile Details

NPI number 1235643479
LBN Legal business name Evans, Robert L
Credentials PHD, LCPC, LPC, MAC,
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 27th, 2017
Last updated May 17th, 2023 - about 3 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 1235643479 NPPES
Maryland MEDICAID 891005700

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