Provider Demographics
NPI:1720472111
Name:EVANS, ALLISON CHRISTINE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:CHRISTINE
Last Name:EVANS
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 1:3361 E HENCART RD
Mailing Address - Street 2:
Mailing Address - City:GLENNVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30427-3208
Mailing Address - Country:US
Mailing Address - Phone:910-391-2297
Mailing Address - Fax:
Practice Address - Street 1:401 BOMBAY LN
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5826
Practice Address - Country:US
Practice Address - Phone:704-664-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11532101YM0800X
NC11532101YM0800X
GALPC011104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health