Provider Demographics
NPI:1194499780
Name:EVENSON COUNSELING, LLC
Entity type:Organization
Organization Name:EVENSON COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:EVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-MH
Authorized Official - Phone:605-777-0075
Mailing Address - Street 1:5000 S BROADBAND LN STE 119
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2261
Mailing Address - Country:US
Mailing Address - Phone:605-777-0075
Mailing Address - Fax:888-977-2561
Practice Address - Street 1:5000 S BROADBAND LN STE 119
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2261
Practice Address - Country:US
Practice Address - Phone:605-777-0075
Practice Address - Fax:888-977-2561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty