Provider Demographics
NPI:1366830366
Name:EVANS, CHASITY MITCHELL (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CHASITY
Middle Name:MITCHELL
Last Name:EVANS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 SEMINOLE LAKES DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4207
Mailing Address - Country:US
Mailing Address - Phone:251-635-7369
Mailing Address - Fax:
Practice Address - Street 1:222 SEMINOLE LAKES DR
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4207
Practice Address - Country:US
Practice Address - Phone:251-635-7369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-14-17062103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst