Provider Demographics
NPI:1558915819
Name:PIERRE, EVENA M (LPC)
Entity Type:Individual
Prefix:
First Name:EVENA
Middle Name:M
Last Name:PIERRE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:EVENA
Other - Middle Name:
Other - Last Name:MEDARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1313 BRADBURY DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-6060
Mailing Address - Country:US
Mailing Address - Phone:847-708-5370
Mailing Address - Fax:
Practice Address - Street 1:1313 BRADBURY DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-6060
Practice Address - Country:US
Practice Address - Phone:847-708-5370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75529103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling