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NPI Code Detail

MEDICARE: CHERI LEE EVANS CDCA

MEDICARE: CHERI LEE EVANS CDCA
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
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.169052OH

General Provider Information

NPI Number : 1821596370
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERI LEE EVANS CDCA
Provider Business Mailing Address
First Line : 328 CHESTNUT ST
Second Line :
City : IRONTON
State : OH
Zip : 45638-1902
Country : US
Telephone Number : 740-550-1829
Fax Number :
Provider Business Practice Location Address
First Line : 1724 S 3RD ST
Second Line :
City : IRONTON
State : OH
Zip : 45638-2269
Country : US
Telephone Number : 740-479-5135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2018
Last Update Date : 09/13/2021

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Directions to “ CHERI LEE EVANS CDCA” Practice Location

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