Provider Demographics
NPI:1306071790
Name:CENTER, EVAN LOUISE (MS, LCPC)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:LOUISE
Last Name:CENTER
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:EVAN
Other - Middle Name:LOUISE
Other - Last Name:RICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS LCPC
Mailing Address - Street 1:321 E MAIN ST STE 407
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4731
Mailing Address - Country:US
Mailing Address - Phone:406-599-5355
Mailing Address - Fax:
Practice Address - Street 1:321 EAST MAIN STREET
Practice Address - Street 2:SUITE 407
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:406-599-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1422101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional