Provider Demographics
NPI:1326617473
Name:EVANS, TUWANA T (LCSW)
Entity Type:Individual
Prefix:DR
First Name:TUWANA
Middle Name:T
Last Name:EVANS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 S LAKESHORE DR STE 207
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7157
Mailing Address - Country:US
Mailing Address - Phone:623-323-8962
Mailing Address - Fax:
Practice Address - Street 1:4801 S LAKESHORE DR STE 207
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7157
Practice Address - Country:US
Practice Address - Phone:623-323-8962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0125761041C0700X
AZLCSW-218971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical