Provider Demographics
NPI:1639465792
Name:EVANS, SHARON MARIE (MC, NCC, LHC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MC, NCC, LHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11779 HIGHWAY 2 STE 105
Mailing Address - Street 2:MITTENWALDER PLATZ
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826-1362
Mailing Address - Country:US
Mailing Address - Phone:509-860-5309
Mailing Address - Fax:
Practice Address - Street 1:11779 HIGHWAY 2 STE 105
Practice Address - Street 2:MITTENWALDER PLATZ
Practice Address - City:LEAVENWORTH
Practice Address - State:WA
Practice Address - Zip Code:98826-1362
Practice Address - Country:US
Practice Address - Phone:509-860-5309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60173010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health