Provider Demographics
NPI:1902406077
Name:MCEVOY, DAWNMARIE ANNE
Entity Type:Individual
Prefix:
First Name:DAWNMARIE
Middle Name:ANNE
Last Name:MCEVOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 220062
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-0062
Mailing Address - Country:US
Mailing Address - Phone:929-306-6928
Mailing Address - Fax:
Practice Address - Street 1:183 MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTER MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11934-1705
Practice Address - Country:US
Practice Address - Phone:929-306-6928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional