Provider Demographics
NPI:1467999730
Name:EVANS, JONATHAN CHRISTOPHER (MSW, LMHPS)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:CHRISTOPHER
Last Name:EVANS
Suffix:
Gender:M
Credentials:MSW, LMHPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1800
Mailing Address - Country:US
Mailing Address - Phone:336-253-3686
Mailing Address - Fax:434-857-5586
Practice Address - Street 1:1045 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1800
Practice Address - Country:US
Practice Address - Phone:336-253-3686
Practice Address - Fax:434-857-5586
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker