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Provider Information for 1750057758


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ERICA EVANS LCSW


Sex: Female

NPI: 1750057758
Last Updated: 2021-08-19
Certification Date: 2021-08-19

Details

NameValue
NPI1750057758
Enumeration Date2021-08-19
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 427 BUCKBOARD LN
LOCUST GROVE, GA 30248-3689
United States

Phone: | Fax:
 
Primary Practice Address 427 BUCKBOARD LN
LOCUST GROVE, GA 30248-3689
United States

Phone: 808-772-2099 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
CONNECT URL
https://www.betterhelp.com/
427 Buckboard Ln
Locust Grove, GA 30248-3689
United States
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalGAcsw007631