Provider Demographics
NPI:1689718900
Name:EVANS, MARGARET ELAINE (LPCC)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ELAINE
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC, ATR-BC
Mailing Address - Street 1:1859 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-5949
Mailing Address - Country:US
Mailing Address - Phone:612-695-1813
Mailing Address - Fax:
Practice Address - Street 1:2637 27TH AVE S STE 240
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-3197
Practice Address - Country:US
Practice Address - Phone:612-444-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00322101YM0800X
MN0552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN25MEEOtherHEALTH PARTNERS