Provider Demographics
NPI:1528477734
Name:EVANS, CORI (MA,LPCI)
Entity type:Individual
Prefix:
First Name:CORI
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:MA,LPCI
Other - Prefix:
Other - First Name:CORI
Other - Middle Name:
Other - Last Name:LAUNCHBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPCI
Mailing Address - Street 1:227 DEVON DR
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-1915
Mailing Address - Country:US
Mailing Address - Phone:864-414-3619
Mailing Address - Fax:
Practice Address - Street 1:110 MANLY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3025
Practice Address - Country:US
Practice Address - Phone:864-298-8026
Practice Address - Fax:864-298-8032
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5704101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional