Healthcare Provider Details

I. General information

NPI: 1942149703
Provider Name (Legal Business Name): EVANS MENTAL WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 CHAPEL DR CRAVEN HOUSE D
DURHAM NC
27708-9984
US

IV. Provider business mailing address

440 CHAPEL DR CRAVEN HOUSE D
DURHAM NC
27708-9984
US

V. Phone/Fax

Practice location:
  • Phone: 919-869-9318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GREGORY CHARLES EVANS
Title or Position: OWNER, LEAD THERAPIST
Credential: LCSW
Phone: 919-869-9318