Provider Demographics
NPI:1891122420
Name:WENDY EVANS COUNSELING, LLC
Entity Type:Organization
Organization Name:WENDY EVANS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-255-4600
Mailing Address - Street 1:83 SMALLS POINT RD
Mailing Address - Street 2:
Mailing Address - City:MACHIASPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04655-3230
Mailing Address - Country:US
Mailing Address - Phone:207-255-6797
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MACHIAS
Practice Address - State:ME
Practice Address - Zip Code:04654-1165
Practice Address - Country:US
Practice Address - Phone:207-255-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC3498251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health