Provider Demographics
NPI:1275311672
Name:EVERS, MAKENNA MORGAN (LCMHCA)
Entity Type:Individual
Prefix:
First Name:MAKENNA
Middle Name:MORGAN
Last Name:EVERS
Suffix:
Gender:F
Credentials:LCMHCA
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 74
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-0074
Mailing Address - Country:US
Mailing Address - Phone:252-573-9235
Mailing Address - Fax:
Practice Address - Street 1:119 W WOOD HILL DR STE 3
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-8700
Practice Address - Country:US
Practice Address - Phone:252-455-2805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19219101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional