Evans, Tim A
Evans, Tim A is an sole proprietor health care provider with primary practice located at 116 Seven Mile Ridge Rd , Burnsville NC 28714-8509. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Evans, Tim A can be contacted via phone (828) 208-9739.Contact Information
Primary practice address
116 Seven Mile Ridge Rd
Burnsville NC 28714-8509
Phone: (828) 208-9739
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C003954 | North Carolina |
Profile Details
| NPI number | 1083706329 |
|---|---|
| LBN Legal business name | Evans, Tim A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Jun 15th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083706329 | NPPES |
| North Carolina | Other | 1352R | NC HEALTH CHOICE |
| North Carolina | Other | 1352R | NC HEALTH CHOICE |
| North Carolina | MEDICAID | 6003015 | NC HEALTH CHOICE |
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