Provider Demographics
NPI:1477167088
Name:EVANS, KENYA (LBSW, MS)
Entity Type:Individual
Prefix:MRS
First Name:KENYA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:LBSW, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 E WHEATLAND RD STE 104
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4918
Mailing Address - Country:US
Mailing Address - Phone:972-283-6799
Mailing Address - Fax:
Practice Address - Street 1:777 E WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4918
Practice Address - Country:US
Practice Address - Phone:972-283-6799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator