Provider Demographics
NPI:1649662529
Name:EVANS, LAURA LINGLE (LCSW-BACS, C-SSWS)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LINGLE
Last Name:EVANS
Suffix:
Gender:F
Credentials:LCSW-BACS, C-SSWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 S TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-5703
Mailing Address - Country:US
Mailing Address - Phone:318-422-6425
Mailing Address - Fax:318-688-2376
Practice Address - Street 1:206 E REYNOLDS DR STE F2
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2809
Practice Address - Country:US
Practice Address - Phone:318-244-7223
Practice Address - Fax:318-688-2376
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA37481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical