Provider Demographics
NPI:1679915656
Name:SITES, EVELYN M (LCSW, CADC)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:M
Last Name:SITES
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 BENNETT CIR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-2842
Mailing Address - Country:US
Mailing Address - Phone:606-862-9132
Mailing Address - Fax:606-862-9334
Practice Address - Street 1:60 BENNETT CIR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-2842
Practice Address - Country:US
Practice Address - Phone:606-862-9132
Practice Address - Fax:606-862-9334
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18251041C0700X
KY0965101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)