Provider Demographics
NPI:1801228218
Name:DILLMAN, EVELYN SARAH (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:SARAH
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 SHILOH RD STE 601
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-2457
Mailing Address - Country:US
Mailing Address - Phone:903-630-5740
Mailing Address - Fax:903-630-5867
Practice Address - Street 1:1810 SHILOH RD STE 601
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-2457
Practice Address - Country:US
Practice Address - Phone:903-630-5740
Practice Address - Fax:903-630-5867
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201697106H00000X
TX67305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist