Provider Demographics
NPI:1700012531
Name:EVAUL, CAROL JANE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JANE
Last Name:EVAUL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W WALL ST
Mailing Address - Street 2:
Mailing Address - City:MULBERRY GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:62262-1080
Mailing Address - Country:US
Mailing Address - Phone:618-326-8694
Mailing Address - Fax:
Practice Address - Street 1:785 WALL ST STE 200
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1959
Practice Address - Country:US
Practice Address - Phone:618-367-2194
Practice Address - Fax:618-726-2024
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)