Provider Demographics
NPI:1497053235
Name:EVANSON-LASS, ERIN ELEANOR (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:ELEANOR
Last Name:EVANSON-LASS
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 1:812 W 8TH ST
Mailing Address - Street 2:STE 6A
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072
Mailing Address - Country:US
Mailing Address - Phone:785-317-2704
Mailing Address - Fax:
Practice Address - Street 1:812 W 8TH ST STE 6A
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-7931
Practice Address - Country:US
Practice Address - Phone:785-317-2704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX609441041C0700X
KS43331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical