Provider Demographics
NPI:1417338948
Name:EVAN, SHANNON (MS)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:EVAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4319 ANNA ST
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1903
Mailing Address - Country:US
Mailing Address - Phone:412-721-2825
Mailing Address - Fax:
Practice Address - Street 1:2100 WHARTON ST
Practice Address - Street 2:SUITE 321
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1972
Practice Address - Country:US
Practice Address - Phone:412-721-2825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health