Provider Demographics
NPI:1902232903
Name:MCLAUGHLIN, EVAN L (LLP)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:L
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39555 ORCHARD HILL PL STE 410
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5523
Mailing Address - Country:US
Mailing Address - Phone:248-952-5444
Mailing Address - Fax:
Practice Address - Street 1:39555 ORCHARD HILL PL STE 410
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5523
Practice Address - Country:US
Practice Address - Phone:248-952-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015163103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical