Provider Demographics
NPI:1063004083
Name:EVANS, WHITNEY (ACMHC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 W MAPLE LOOP DR STE 202
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4602
Mailing Address - Country:US
Mailing Address - Phone:385-254-3522
Mailing Address - Fax:
Practice Address - Street 1:3051 W MAPLE LOOP DR STE 202
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4602
Practice Address - Country:US
Practice Address - Phone:385-254-3522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11520184-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health