Organization
EVANS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY CHARLES EVANS PH.D. (LICENSED PSYCHOLOGIST, OWNER)
(715) 849-3988
Entity
Organization
Contact information
Practice address
2714 STEWART AVE, WAUSAU, WI 54401-4153
(715) 849-3988
(715) 849-5838
Mailing address
2714 STEWART AVE, WAUSAU, WI 54401-4153
(715) 849-3988
(715) 849-5838
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39120800
—
WI
Enumeration date
05/21/2007
Last updated
08/22/2020
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