Organization
PATRICE EVANS COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICE MAREE EVANS LMSW (CLINICAL SOCIAL WORKER)
(906) 387-6404
Entity
Organization
Contact information
Practice address
N3936 W LOST LAKE RD, WETMORE, MI 49895-9581
(906) 387-6404
Mailing address
PO BOX 435, MUNISING, MI 49862-0435
(906) 387-6404
(906) 387-6405
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
680185455
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639364706
INDIVIDUAL NPI
MI
Enumeration date
10/12/2011
Last updated
02/06/2022
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