Healthcare Provider Details

I. General information

NPI: 1568752566
Provider Name (Legal Business Name): MARY C EVANS LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2902 SW ASBURY DR
TOPEKA KS
66614-4466
US

IV. Provider business mailing address

2902 SW ASBURY DR
TOPEKA KS
66614-4466
US

V. Phone/Fax

Practice location:
  • Phone: 785-270-4630
  • Fax: 785-270-4628
Mailing address:
  • Phone: 785-270-4630
  • Fax: 785-270-4628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4353
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: