Provider Demographics
NPI:1063062677
Name:EVNEN, JUDITH ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:EVNEN
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 1:2229 CONDOLEA TER
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1660
Mailing Address - Country:US
Mailing Address - Phone:913-461-6065
Mailing Address - Fax:
Practice Address - Street 1:3100 BROADWAY BLVD STE 410
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2655
Practice Address - Country:US
Practice Address - Phone:816-753-3333
Practice Address - Fax:816-256-2780
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical