Provider Demographics
NPI:1760659718
Name:EVERS, PATRICIA LEAH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LEAH
Last Name:EVERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:P.
Other - Middle Name:LEAH
Other - Last Name:EVERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1815 PLEASANT GROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-7870
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-336-1339
Practice Address - Street 1:2305 OLD COUNTY ROAD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-4148
Practice Address - Country:US
Practice Address - Phone:870-892-1005
Practice Address - Fax:870-892-0078
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
AR2233-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5R173OtherBCBS
AR174465795Medicaid
AR5R173OtherBCBS