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General NPI Number Information
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NPI Number | 1972130706
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Entity Type | Individual
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Provider Name | AARON JAMES EVANS LPC
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Gender | Male
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 3200 W HIGHLAND BLVD
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City | MILWAUKEE
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State | WI
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Zip | 53208-3252
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Country | US
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Telephone | 414-342-4560
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Fax |
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Provider Business Mailing Address
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Address Line | 6338 W GLENBROOK RD
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City | MILWAUKEE
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State | WI
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Zip | 53223-1538
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Country | US
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Telephone | 414-350-0339
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6810-125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6810-125
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License Number State | WI
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