MEDICARE: MS. MARGARET ELAINE EVANS LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	00322	MN
2	101YM0800X	Mental Health Counselor	0552	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25MEE	OTHER	MN	HEALTH PARTNERS

General Provider Information

NPI Number	:	1689718900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET ELAINE EVANS LPCC

Provider Business Mailing Address
First Line	:	1859 ASHLAND AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-5949
Country	:	US
Telephone Number	:	612-695-1813
Fax Number	:

Provider Business Practice Location Address
First Line	:	2637 27TH AVE S STE 240
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3197
Country	:	US
Telephone Number	:	612-444-5820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	11/06/2023

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