Provider Information for 1619126869
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Mr. SEAN DAVID EVANS LPCC, LPC
Sex: Male
NPI: 1619126869
Last Updated: 2021-06-18
Certification Date: 2021-06-18
Certification Date: 2021-06-18
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1619126869 | ||||||||||||
| Enumeration Date | 2008-09-11 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 316 SAWYER DR DURANGO, CO 81303-6560 United States Phone: 970-759-3878 | Fax:970-259-6605 | ||||||||||||
| Primary Practice Address | 201 NORTH RD DURANGO, CO 81303-6430 United States Phone: 970-759-3878 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 281 SAWYER DR 316 SAWYER DR | ||||||||||||
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