Provider Demographics
NPI:1659690154
Name:EVANS, JENNIFER JOHNSTON (MED, LPC-MHSP, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JOHNSTON
Last Name:EVANS
Suffix:
Gender:F
Credentials:MED, LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E MAIN ST
Mailing Address - Street 2:5
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3898
Mailing Address - Country:US
Mailing Address - Phone:615-822-0341
Mailing Address - Fax:
Practice Address - Street 1:313 E MAIN ST
Practice Address - Street 2:5
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3898
Practice Address - Country:US
Practice Address - Phone:615-822-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000002235101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional