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General NPI Number Information
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NPI Number | 1881264521
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Entity Type | Individual
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Provider Name | LOGAN DEAN EVANS LCSW
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Gender |
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 10/19/2025
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Provider Practice Location Address
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Address Line | 921 E NEW YORK AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-1393
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Country | US
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Telephone | 718-778-0485
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Fax |
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Provider Business Mailing Address
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Address Line | 921 E NEW YORK AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-1393
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Country | US
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Telephone | 718-778-0485
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 099464
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License Number State | NY
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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 | 108469
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License Number State | NY
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