Provider Demographics
NPI:1225862386
Name:EVANS PSYCHOLOGICAL AND COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:EVANS PSYCHOLOGICAL AND COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, HSPP
Authorized Official - Phone:812-552-1650
Mailing Address - Street 1:911 PEREGRINE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-1765
Mailing Address - Country:US
Mailing Address - Phone:812-552-1650
Mailing Address - Fax:
Practice Address - Street 1:2520 CALIFORNIA ST STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-3677
Practice Address - Country:US
Practice Address - Phone:812-552-1650
Practice Address - Fax:812-376-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty