Provider Demographics
NPI:1932595238
Name:EVANS, RACHEL ERIN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ERIN
Last Name:EVANS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EMBEDDED BEHAVIORAL HEALTH TEAM 3
Mailing Address - Street 2:1364 BARKELEY AVE. BLDG 1150
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913
Mailing Address - Country:US
Mailing Address - Phone:719-503-7863
Mailing Address - Fax:
Practice Address - Street 1:EMBEDDED BEHAVIORAL HEALTH TEAM 3
Practice Address - Street 2:1364 BARKELEY AVE. BLDG 1150
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-503-7836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9094598-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker