Provider Demographics
NPI:1639068414
Name:CARMODY, EVANGELINE (LPC)
Entity type:Individual
Prefix:
First Name:EVANGELINE
Middle Name:
Last Name:CARMODY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:EVANGELINE
Other - Middle Name:
Other - Last Name:DURAN-MONTEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1007 S PASTURE DR
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-4543
Mailing Address - Country:US
Mailing Address - Phone:702-283-8197
Mailing Address - Fax:512-671-9415
Practice Address - Street 1:3000 JOE DIMAGGIO BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3922
Practice Address - Country:US
Practice Address - Phone:512-298-2440
Practice Address - Fax:512-671-9415
Is Sole Proprietor?:No
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97826101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health