Provider Demographics
NPI:1871860619
Name:WOODWARD, EVELYN DARAN-DAWSON (LCSW, CEAP)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:DARAN-DAWSON
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:LCSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 HARRINGTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-4919
Mailing Address - Country:US
Mailing Address - Phone:904-220-3645
Mailing Address - Fax:
Practice Address - Street 1:1537 HARRINGTON PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-4919
Practice Address - Country:US
Practice Address - Phone:904-220-3645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW42531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical