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General NPI Number Information
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NPI Number | 1598641797
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Entity Type | Individual
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Provider Name | JADARIUS STEPHON EVANS
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Gender | Male
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 250 DEWEY AVE
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City | SPARTANBURG
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State | SC
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Zip | 29303-3009
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Country | US
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Telephone | 864-585-0366
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Fax |
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Provider Business Mailing Address
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Address Line | 660 HALTON RD APT 2M
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City | GREENVILLE
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State | SC
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Zip | 29607-3449
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10554
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License Number State | SC
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