Provider Demographics
NPI:1891915831
Name:EVANS, JONATHAN (MA)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:EVANS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 E 4TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301-2419
Mailing Address - Country:US
Mailing Address - Phone:814-440-9989
Mailing Address - Fax:
Practice Address - Street 1:248 SENECA ST
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-1371
Practice Address - Country:US
Practice Address - Phone:814-678-8627
Practice Address - Fax:814-676-1016
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health