Healthcare Provider Details
I. General information
NPI: 1770847261
Provider Name (Legal Business Name): LINDSAY EVANS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/28/2012
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2600 OAKLAND AVE
ELKHART IN
46517-1533
US
IV. Provider business mailing address
7819 LANGWOOD DR
INDIANAPOLIS IN
46268-4793
US
V. Phone/Fax
- Phone: 317-431-6938
- Fax:
- Phone: 317-431-6938
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 34007411A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: