Provider Demographics
NPI:1447589577
Name:EVANS, PATRICIA (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:EVANS
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 1:7027 VOIGHT RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1521
Mailing Address - Country:US
Mailing Address - Phone:215-483-7168
Mailing Address - Fax:
Practice Address - Street 1:7600 STENTON AVE STE 1F
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3245
Practice Address - Country:US
Practice Address - Phone:215-247-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-20
Last Update Date:2009-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional