Provider Demographics
NPI:1699363705
Name:NADEL, EVAN CRAIG (LMSW)
Entity type:Individual
Prefix:MR
First Name:EVAN
Middle Name:CRAIG
Last Name:NADEL
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 E END RD
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7201
Mailing Address - Country:US
Mailing Address - Phone:907-226-2228
Mailing Address - Fax:907-226-2230
Practice Address - Street 1:880 E END RD
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7201
Practice Address - Country:US
Practice Address - Phone:907-226-2228
Practice Address - Fax:907-226-2230
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097549104100000X
AK225830104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker