Provider Demographics
NPI:1003418468
Name:MCEVILLY COUNSELING PLLC
Entity Type:Organization
Organization Name:MCEVILLY COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCEVILLY
Authorized Official - Suffix:III
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-736-7251
Mailing Address - Street 1:1210 N CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4604
Mailing Address - Country:US
Mailing Address - Phone:248-736-7251
Mailing Address - Fax:
Practice Address - Street 1:120 E LIBERTY ST # ST360
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2156
Practice Address - Country:US
Practice Address - Phone:248-736-7251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health