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Individual

DEZIRAE MCEVOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
4344 N 62ND ST STE 5, LINCOLN, NE 68507-1251
(308) 360-2444
Mailing address
4344 N 62ND ST STE 5, LINCOLN, NE 68507-1251
(308) 360-2444

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2053
NE
1041C0700X
Clinical Social Worker
1769
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11007
NE PLMHP LICENSURE
NE
01
1769
NEBRASKA LICENSED MASTER SOCIAL WORKER
NE
01
2053
NEBRASKA LICENSED INDEPENDENT MENTAL HEALTH PRACTITIONER (LIMHP)
NE
Enumeration date
09/12/2016
Last updated
01/16/2024
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