Individual
ELISSA CAE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
88 E FIDDLERS CANYON RD STE 122, CEDAR CITY, UT 84721-9787
(702) 775-2738
Mailing address
PO BOX 784, PANACA, NV 89042-0784
(702) 461-6484
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
00833-C
NV
101YM0800X
Mental Health Counselor
Primary
11968-C
NV
101YM0800X
Mental Health Counselor
13063034-3501
UT
Other
Enumeration date
08/14/2019
Last updated
02/18/2025
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