Provider Demographics
NPI:1124253562
Name:EVANS, ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
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 1:8121 NATIONAL AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7572
Mailing Address - Country:US
Mailing Address - Phone:405-733-5437
Mailing Address - Fax:405-732-7741
Practice Address - Street 1:621 NW 21ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1809
Practice Address - Country:US
Practice Address - Phone:405-528-7724
Practice Address - Fax:405-528-0394
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker