Provider Demographics
NPI:1821053141
Name:EVANS, ANNE ELIZABETH (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:ANNE ELIZABETH
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 E. ELIZABETH AVE
Mailing Address - Street 2:SUITE 612
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018
Mailing Address - Country:US
Mailing Address - Phone:484-866-7346
Mailing Address - Fax:
Practice Address - Street 1:65 E. ELIZABETH AVE.
Practice Address - Street 2:SUITE 612
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:484-866-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS4914L103T00000X
PAMF000069106H00000X
PAPS4914-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01872801OtherCBC
02751300OtherGR
010895800OtherIBC
PA501528OtherHIGHMARK B.S.