Provider Demographics
NPI:1063550259
Name:EVANS, JOANNE M (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:M
Last Name:EVANS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JODI
Other - Middle Name:M
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:257 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-2359
Mailing Address - Country:US
Mailing Address - Phone:928-783-2427
Mailing Address - Fax:928-783-0633
Practice Address - Street 1:257 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-2359
Practice Address - Country:US
Practice Address - Phone:928-783-2427
Practice Address - Fax:928-783-0633
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ104371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical