| Evans Counseling, Llc | |
|
2714 Stewart Ave Wausau WI 54401-4153 | |
| (715) 849-3988 | |
| (715) 849-5838 |
| Full Name | Evans Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2714 Stewart Ave, Wausau, Wisconsin |
| Authorized Official Name and Position | Kelly Charles Evans (LICENSED PSYCHOLOGIST, OWNER) |
| Authorized Official Contact | 7158493988 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evans Counseling, Llc 2714 Stewart Ave Wausau WI 54401-4153 Ph: (715) 849-3988 | Evans Counseling, Llc 2714 Stewart Ave Wausau WI 54401-4153 Ph: (715) 849-3988 |
| NPI Number | 1215146907 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9931271681 |
|---|---|
| Medicare Enrollment ID | O20080711000562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215146907 | NPI | - | NPPES |
| 39120800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2027 (Wisconsin) | Primary |
| Provider Name | Kelly C Evans |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720165251 PECOS PAC ID: 2769554419 Enrollment ID: I20080711000561 |
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