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Individual

MRS. JACQUELINE ROSE EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DBH, LCSW, LCADC

Contact information

Practice address
9402 W LAKE MEAD BLVD OFC 105, LAS VEGAS, NV 89134-8312
(702) 381-3414
(702) 254-7830
Mailing address
9402 W LAKE MEAD BLVD OFC 105, LAS VEGAS, NV 89134-8312
(702) 381-3414
(702) 254-7830

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
00302-C
NV
1041C0700X
Clinical Social Worker
Primary
7063-C

Other

Enumeration date
03/03/2013
Last updated
06/17/2025
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