Provider Demographics
NPI:1033449087
Name:EVANS, JENNIFER N (LPC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:N
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 DENHOLM DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7900
Mailing Address - Country:US
Mailing Address - Phone:757-447-4629
Mailing Address - Fax:757-671-8536
Practice Address - Street 1:1418 DENHOLM DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7900
Practice Address - Country:US
Practice Address - Phone:757-447-4629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004750101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional