Provider Demographics
NPI:1073756961
Name:MCEVERS, TRISHA ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANN
Last Name:MCEVERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:ANN
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 E. LAKESHORE DRIVE, SUITE 102
Mailing Address - Street 2:
Mailing Address - City:MANISTIQUE
Mailing Address - State:MI
Mailing Address - Zip Code:49854
Mailing Address - Country:US
Mailing Address - Phone:906-286-3294
Mailing Address - Fax:
Practice Address - Street 1:601 E. LAKESHORE DRIVE, SUITE 102
Practice Address - Street 2:
Practice Address - City:MANISTIQUE
Practice Address - State:MI
Practice Address - Zip Code:49854
Practice Address - Country:US
Practice Address - Phone:906-286-3294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010782191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical