Provider Demographics
NPI:1952799603
Name:EVALUATION AND EDUCATION SERVICES, LLC
Entity Type:Organization
Organization Name:EVALUATION AND EDUCATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:P
Authorized Official - Last Name:IRWIN-SMILER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:336-245-8161
Mailing Address - Street 1:2910 BRIARCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3176
Mailing Address - Country:US
Mailing Address - Phone:336-245-8161
Mailing Address - Fax:336-773-0332
Practice Address - Street 1:2910 BRIARCLIFFE RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106
Practice Address - Country:US
Practice Address - Phone:336-245-8161
Practice Address - Fax:336-773-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS2165101Y00000X
NCLPA4067103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty