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General NPI Number Information
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NPI Number | 1285316661
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Entity Type | Individual
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Provider Name | MELODY MICHELLE EVANS MSW
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Gender | Female
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 3200 SW 34TH AVE STE 701
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City | OCALA
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State | FL
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Zip | 34474-8443
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Country | US
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Telephone | 877-779-2429
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Fax |
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Provider Business Mailing Address
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Address Line | 5468 MOONGATE RD
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City | SPRING HILL
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State | FL
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Zip | 34606-1246
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Country | US
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Telephone | 863-808-7952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ISW16026
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW22080
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License Number State | FL
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