Provider Demographics
NPI:1700207636
Name:EDDY, EVELYN J (CADC, MAC)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:J
Last Name:EDDY
Suffix:
Gender:F
Credentials:CADC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3610
Mailing Address - Country:US
Mailing Address - Phone:724-202-6818
Mailing Address - Fax:724-202-6995
Practice Address - Street 1:4 N MILL ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3610
Practice Address - Country:US
Practice Address - Phone:724-202-6818
Practice Address - Fax:724-202-6995
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
509168101YA0400X
PA6838101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)