Provider / Organization | NPI | Date Certified |
---|---|---|
MAHLEE EVANS | 1376392837 | 2024-11-10 |
Mahlee Evans is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1376392837. Registration indicates Mahlee Evans is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor, Behavioral Health & Social Service Providers)
Entity Type | Individual |
Provider Name | Mahlee Evans CT |
Practice Office Address | 4522 FULTON DR NW CANTON, OH US |
Practice Office Telephone | 3309152907 |
Practice Office Fax | 3309152958 |
Mailing Address | 4522 FULTON DR NW CANTON, OH 447182332 US |
Business Telephone | 3309152907 |
Business Fax | 3309152958 |
Address | City / State | Phone / Fax |
---|---|---|
4200 Munson St NW Ste A | Canton, OH 447182981 | 3309152907 / 3309152958 |
Code | Practice | License No State |
---|---|---|
101Y00000X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor Behavioral Health/Substance Abuse/Psychiatry Counselor Behavioral Health & Social Service Providers | C.2405801-TRNE
OH |
0074064 | MEDICAID | OH |