Provider Demographics
NPI:1134850548
Name:EVANS-FULTON ASSESSMENT AND CONSULTATION, LLC
Entity type:Organization
Organization Name:EVANS-FULTON ASSESSMENT AND CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS-FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC (VA), NCC
Authorized Official - Phone:276-477-4174
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212-0544
Mailing Address - Country:US
Mailing Address - Phone:276-477-4174
Mailing Address - Fax:
Practice Address - Street 1:26108 BEECH CIR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7262
Practice Address - Country:US
Practice Address - Phone:276-477-4174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)