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General NPI Number Information
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NPI Number | 1255214581
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Entity Type | Organization
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Legal Business Name | THE EVANS GROUP LLC
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 5445 32ND AVE STE 180
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City | HUDSONVILLE
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State | MI
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Zip | 49426-2408
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Country | US
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Telephone | 616-307-6855
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Fax |
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Provider Business Mailing Address
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Address Line | 3379 KINGS RIVER ST SW
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City | WYOMING
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State | MI
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Zip | 49418-8822
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Country | US
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Telephone | 616-307-6855
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MR. WILLIAM EVANS
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Credential | LPC
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Telephone | 616-307-6855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NULL
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