Provider Demographics
NPI:1285528901
Name:JOHNS, EVAN (LADC)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:JOHNS
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 LOWER JAFFREY RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03444-8718
Mailing Address - Country:US
Mailing Address - Phone:617-990-2517
Mailing Address - Fax:
Practice Address - Street 1:17 KIT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-5911
Practice Address - Country:US
Practice Address - Phone:603-439-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1309101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty