| Joanna P Evans Lcsw Pllc | |
|
1145 A Executive Circle Cary NC 27511-4586 | |
| (919) 434-6147 | |
| Not Available |
| Full Name | Joanna P Evans Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1145 A Executive Circle, Cary, North Carolina |
| Authorized Official Name and Position | Joanna Patricia Evans (PRESIDENT) |
| Authorized Official Contact | 9194346147 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joanna P Evans Lcsw Pllc P.o. Box 1600 Cary NC 27512 Ph: (919) 434-6147 | Joanna P Evans Lcsw Pllc 1145 A Executive Circle Cary NC 27511-4586 Ph: (919) 434-6147 |
| NPI Number | 1669586046 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 06/22/2022 |
| Certification Date | 06/22/2022 |
| Medicare PECOS PAC ID | 4981091899 |
|---|---|
| Medicare Enrollment ID | O20220425000272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669586046 | NPI | - | NPPES |
| 298254000 | Other | NC | MAGELLAN |
| 6106326 | Medicaid | NC | |
| 130P6 | Other | NC | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C002879 (North Carolina) | Primary |
| Provider Name | Joanna P Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700847639 PECOS PAC ID: 2961507553 Enrollment ID: I20070410000145 |
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