| Heather R Evans | |
|
124 S Main St Coopersburg PA 18036-1913 | |
| (610) 282-5735 | |
| Not Available |
| Full Name | Heather R Evans |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 124 S Main St, Coopersburg, Pennsylvania |
| Authorized Official Name and Position | Heather R Evans (DIRECTOR) |
| Authorized Official Contact | 6102825735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heather R Evans 124 S Main St Coopersburg PA 18036-1913 Ph: (610) 282-5735 | Heather R Evans 124 S Main St Coopersburg PA 18036-1913 Ph: (610) 282-5735 |
| NPI Number | 1952727489 |
|---|---|
| Provider Enumeration Date | 03/07/2014 |
| Last Update Date | 02/16/2021 |
| Certification Date | 01/14/2021 |
| Medicare PECOS PAC ID | 0143631184 |
|---|---|
| Medicare Enrollment ID | O20201124001733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952727489 | NPI | - | NPPES |
| 1952727489 | Other | PA | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CW014556 (Pennsylvania) | Primary |
| Provider Name | Heather R Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659476372 PECOS PAC ID: 5496751455 Enrollment ID: I20061013000535 |
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