Provider Demographics
NPI:1356606925
Name:EVANS, HILLARY PAIGE (LCSW)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:PAIGE
Last Name:EVANS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 MOSSER ROAD
Mailing Address - Street 2:UNIT X-201
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031
Mailing Address - Country:US
Mailing Address - Phone:267-893-5056
Mailing Address - Fax:
Practice Address - Street 1:1063 MOSSER ROAD
Practice Address - Street 2:UNIT X-201
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031
Practice Address - Country:US
Practice Address - Phone:330-447-8313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS12004251041C0700X
PACW0187621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN165490139Medicare PIN