Provider Demographics
NPI:1538294301
Name:BUJA, EVAN L (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:EVAN
Middle Name:L
Last Name:BUJA
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9014 EUSTIS AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-4208
Mailing Address - Country:US
Mailing Address - Phone:214-557-2247
Mailing Address - Fax:
Practice Address - Street 1:2625 N JOSEY LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5543
Practice Address - Country:US
Practice Address - Phone:972-466-2800
Practice Address - Fax:972-466-2810
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18310101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional