Provider Demographics
NPI:1932481165
Name:EVERS, PATRICE DEAN (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:DEAN
Last Name:EVERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N BAKER CIR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-9714
Mailing Address - Country:US
Mailing Address - Phone:512-466-1486
Mailing Address - Fax:512-777-5048
Practice Address - Street 1:1004 W 31ST ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2002
Practice Address - Country:US
Practice Address - Phone:512-466-1486
Practice Address - Fax:512-777-5048
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67720101YP2500X, 101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor