Provider Demographics
NPI:1336323716
Name:EVANO, EVELYN (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:EVANO
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 E 50TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3502
Mailing Address - Country:US
Mailing Address - Phone:541-686-2527
Mailing Address - Fax:888-975-9439
Practice Address - Street 1:550 E 50TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3502
Practice Address - Country:US
Practice Address - Phone:541-686-2527
Practice Address - Fax:888-975-9439
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2113101YP2500X
ORT0586106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional