Provider Demographics
NPI:1780429332
Name:EVANS, NAJEE SHAMAR
Entity type:Individual
Prefix:
First Name:NAJEE
Middle Name:SHAMAR
Last Name:EVANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MIND AND SOUL TELEWELLNESS, LLC
Mailing Address - Street 2:320 E TOWSONTOWN BLVD STE 201
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5331
Mailing Address - Country:US
Mailing Address - Phone:443-953-8522
Mailing Address - Fax:855-955-1334
Practice Address - Street 1:MIND AND SOUL TELEWELLNESS, LLC
Practice Address - Street 2:320 E TOWSONTOWN BLVD STE 201
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21153
Practice Address - Country:US
Practice Address - Phone:443-953-8522
Practice Address - Fax:855-955-1334
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
31434104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker