Provider Demographics
NPI:1750029831
Name:EVANS, ANDREA M (LCASA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:EVANS
Suffix:
Gender:F
Credentials:LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8322 COUNTRY OAKS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-5936
Mailing Address - Country:US
Mailing Address - Phone:980-345-9997
Mailing Address - Fax:
Practice Address - Street 1:11020 S TRYON ST STE 408
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6662
Practice Address - Country:US
Practice Address - Phone:980-236-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)