Provider Demographics
NPI:1972643724
Name:EVANS, LAWRENCE T (DOCTOR OF MINISTRY)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:T
Last Name:EVANS
Suffix:
Gender:M
Credentials:DOCTOR OF MINISTRY
Other - Prefix:DR
Other - First Name:LARRY
Other - Middle Name:T
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DOCTOR OF MINISTRY
Mailing Address - Street 1:1037 WOODRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2257
Mailing Address - Country:US
Mailing Address - Phone:717-892-6938
Mailing Address - Fax:
Practice Address - Street 1:1037 WOODRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2257
Practice Address - Country:US
Practice Address - Phone:717-898-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001987101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional