Provider Demographics
NPI:1417581778
Name:EVORS, HANNAH BROOKE (LCSW)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:BROOKE
Last Name:EVORS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5715 MEADOW WOOD DR
Mailing Address - Street 2:
Mailing Address - City:BLACKSHEAR
Mailing Address - State:GA
Mailing Address - Zip Code:31516-4490
Mailing Address - Country:US
Mailing Address - Phone:912-288-4872
Mailing Address - Fax:
Practice Address - Street 1:311 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:GA
Practice Address - Zip Code:31546-4872
Practice Address - Country:US
Practice Address - Phone:912-530-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0070821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical