Healthcare Provider Details

I. General information

NPI: 1073057865
Provider Name (Legal Business Name): MICHELLE JEANETTE EVELAND MSW, LICSW, CMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE JEANETTE SCULLY MSW, LSWAIC

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 N MONROE ST # 115
SPOKANE WA
99201-2623
US

IV. Provider business mailing address

1312 N MONROE ST # 115
SPOKANE WA
99201-2623
US

V. Phone/Fax

Practice location:
  • Phone: 509-329-8413
  • Fax:
Mailing address:
  • Phone: 509-329-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSC60443410
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60904652
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: