Provider Demographics
NPI:1295027324
Name:JARSCHAUER, EVAN (MAC, LMCH, CAP, MBA)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:JARSCHAUER
Suffix:
Gender:M
Credentials:MAC, LMCH, CAP, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 GLADES RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4150
Mailing Address - Country:US
Mailing Address - Phone:800-787-1721
Mailing Address - Fax:
Practice Address - Street 1:7777 GLADES RD STE 100
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4150
Practice Address - Country:US
Practice Address - Phone:800-787-1721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP2944101YA0400X
FLMH7924101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)