Provider Demographics
NPI:1215596184
Name:TEJAS, EVELYN JEANNETTE (MHC)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:JEANNETTE
Last Name:TEJAS
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:II5 ALTURAS DE BORINQUEN GARDENS
Mailing Address - Street 2:COURT 3
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-457-2211
Mailing Address - Fax:
Practice Address - Street 1:200 CALLE NORZAGARAY
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-1122
Practice Address - Country:US
Practice Address - Phone:787-725-5358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)