Provider Demographics
NPI:1326674037
Name:EVANS, BRIDGJETTE MONIQUE (LPC)
Entity Type:Individual
Prefix:
First Name:BRIDGJETTE
Middle Name:MONIQUE
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 VICTORIAN RUN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2535
Mailing Address - Country:US
Mailing Address - Phone:713-553-9751
Mailing Address - Fax:
Practice Address - Street 1:120 ELDRIDGE RD STE C
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4640
Practice Address - Country:US
Practice Address - Phone:713-234-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-14
Last Update Date:2020-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health