Provider Demographics
NPI:1407397904
Name:EVARTT, CAROLYN (LPC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:EVARTT
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 1:118 W HEARD ST STE H
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-3800
Mailing Address - Country:US
Mailing Address - Phone:817-645-5517
Mailing Address - Fax:817-645-5715
Practice Address - Street 1:118 W HEARD ST STE H
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-3800
Practice Address - Country:US
Practice Address - Phone:817-645-5517
Practice Address - Fax:817-645-5715
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74969101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional