Provider Demographics
NPI:1013382605
Name:EVERS, KRISTIN LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LYNN
Last Name:EVERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE 1200 A
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-371-7838
Mailing Address - Fax:269-341-6261
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE 1200 A
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-371-7838
Practice Address - Fax:269-341-6261
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010889591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical