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General NPI Number Information
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NPI Number | 1508375932
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Entity Type | Individual
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Provider Name | KAREN M EVANS
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Gender | Female
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 3790 OLD US HIGHWAY 41 N STE A
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City | VALDOSTA
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State | GA
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Zip | 31602-6865
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Country | US
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Telephone | 229-262-1000
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Fax | 229-262-1085
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Provider Business Mailing Address
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Address Line | 1609 LUTZ FARM RD
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City | DU PONT
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State | GA
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Zip | 31630-2803
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Country | US
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Telephone | 912-487-6529
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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 | MSW004781
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW006351
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License Number State | GA
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