MEDICARE: MICHAEL LYNN EVANS LCSW

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	1041C0700X	Clinical Social Worker	7186-C	AR

General Provider Information

NPI Number	:	1770835068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL LYNN EVANS LCSW

Provider Business Mailing Address
First Line	:	270 PIONEER LN
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-8826
Country	:	US
Telephone Number	:	501-701-0088
Fax Number	:	501-620-5109

Provider Business Practice Location Address
First Line	:	1401 MALVERN AVE STE 152
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-6370
Country	:	US
Telephone Number	:	501-701-0088
Fax Number	:	888-313-1371

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

Provider Enumeration Date	:	10/10/2012
Last Update Date	:	04/17/2024

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