Provider Demographics
NPI:1336522663
Name:EVANS, ELVIRA (MSW)
Entity type:Individual
Prefix:MRS
First Name:ELVIRA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 BRUMMELL LN
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-3212
Mailing Address - Country:US
Mailing Address - Phone:336-944-7609
Mailing Address - Fax:
Practice Address - Street 1:521 BRUMMELL LN
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3212
Practice Address - Country:US
Practice Address - Phone:336-944-7609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23177101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)