Healthcare Provider Details

I. General information

NPI: 1740115021
Provider Name (Legal Business Name): LARISSA EVANS MINDFULNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 WORTH ST
PITTSBURGH PA
15217-1323
US

IV. Provider business mailing address

612 WORTH ST
PITTSBURGH PA
15217-1323
US

V. Phone/Fax

Practice location:
  • Phone: 703-638-3881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LARISSA EVANS
Title or Position: OWNER
Credential: LMFT
Phone: 703-638-3881