Healthcare Provider Details

I. General information

NPI: 1578951786
Provider Name (Legal Business Name): BARBARA EVANS ED.D., LCPC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2014
Last Update Date: 09/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N NAPER BLVD SUITE 200
NAPERVILLE IL
60563-8802
US

IV. Provider business mailing address

1717 N NAPER BLVD SUITE 200
NAPERVILLE IL
60563-8802
US

V. Phone/Fax

Practice location:
  • Phone: 630-848-9200
  • Fax:
Mailing address:
  • Phone: 630-848-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00016183
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.007666
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: