Provider Demographics
NPI:1831762194
Name:HARRINGTON, EVELYN
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18814 ILION AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-1942
Mailing Address - Country:US
Mailing Address - Phone:917-325-5581
Mailing Address - Fax:718-454-4121
Practice Address - Street 1:18814 ILION AVE
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-1942
Practice Address - Country:US
Practice Address - Phone:917-325-5581
Practice Address - Fax:718-454-4121
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR056635-01101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional