Provider Demographics
NPI:1083766992
Name:EVANS, RICHANDE LATOYA (LMSW)
Entity Type:Individual
Prefix:
First Name:RICHANDE
Middle Name:LATOYA
Last Name:EVANS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:RASHONDA
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:781 E 142ND ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-1723
Mailing Address - Country:US
Mailing Address - Phone:717-993-1400
Mailing Address - Fax:718-993-0647
Practice Address - Street 1:781 E 142ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1723
Practice Address - Country:US
Practice Address - Phone:717-993-1400
Practice Address - Fax:718-993-0647
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074004104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker