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General NPI Number Information
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NPI Number | 1336688902
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Entity Type | Individual
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Provider Name | JULIA EVANS LCSW, CADC
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Gender | Female
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 25 E WASHINGTON ST #2036
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City | CHICAGO
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State | IL
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Zip | 60602-1708
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Country | US
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Telephone | 860-490-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 58 GOVERNORS WAY
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City | MADISON
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State | CT
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Zip | 06443-2178
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Country | US
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Telephone | 860-490-4010
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 32996
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.101987
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149019336
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 012096
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License Number State | CT
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