Provider Demographics
NPI:1790385003
Name:EVANS, WILLIAM BATTLE (PH D)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BATTLE
Last Name:EVANS
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7021
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29861-7021
Mailing Address - Country:US
Mailing Address - Phone:706-627-6353
Mailing Address - Fax:
Practice Address - Street 1:1608 WOODHILL TRL
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2664
Practice Address - Country:US
Practice Address - Phone:706-627-6353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4744103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool