Individual
JOSEPH OTHELLO EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1810 BACK CREEK DR, CHARLOTTE, NC 28213-2159
(844) 263-0050
Mailing address
156 MADISON AVE NE, CONCORD, NC 28025-3222
(336) 858-6862
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-29928
NC
101YM0800X
Mental Health Counselor
Primary
A20180
NC
Other
Enumeration date
03/25/2021
Last updated
09/24/2024
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