Provider Demographics
NPI:1164730610
Name:EVANS, CATHERINE FLY (LPCMH)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:FLY
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 UNION ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-1622
Mailing Address - Country:US
Mailing Address - Phone:302-362-7212
Mailing Address - Fax:302-883-8024
Practice Address - Street 1:306 UNION ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-1622
Practice Address - Country:US
Practice Address - Phone:302-362-7212
Practice Address - Fax:302-883-8024
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004882101YP2500X
DEPC-0000587101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional