Provider Demographics
NPI:1902308190
Name:KATIE EVANS PROFESSIONAL COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:KATIE EVANS PROFESSIONAL COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-688-4173
Mailing Address - Street 1:8810 S YALE AVE UNIT I
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3551
Mailing Address - Country:US
Mailing Address - Phone:918-688-4173
Mailing Address - Fax:
Practice Address - Street 1:8810 S YALE AVE UNIT I
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-3551
Practice Address - Country:US
Practice Address - Phone:918-688-4173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-02
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty