Healthcare Provider Details
I. General information
NPI: 1487583225
Provider Name (Legal Business Name): EVANS COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
357 W CENTER ST STE 210
POCATELLO ID
83204-3236
US
IV. Provider business mailing address
357 W CENTER ST STE 210
POCATELLO ID
83204-3236
US
V. Phone/Fax
- Phone: 208-757-7718
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CODY
EVANS
Title or Position: PRESIDENT
Credential: LCPC
Phone: 208-757-7718