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General NPI Number Information
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NPI Number | 1952727489
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Entity Type | Organization
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Legal Business Name | EVANS COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 03/07/2014
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 124 S MAIN ST
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City | COOPERSBURG
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State | PA
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Zip | 18036-1913
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Country | US
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Telephone | 610-282-5735
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Fax |
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Provider Business Mailing Address
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Address Line | 124 S MAIN ST
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City | COOPERSBURG
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State | PA
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Zip | 18036-1913
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Country | US
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Telephone | 610-282-5735
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. HEATHER R EVANS
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Credential | DSW, LCSW
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Telephone | 610-282-5735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | CW014556
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License Number State | PA
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