Provider Demographics
NPI:1861041576
Name:EVANS WEISS, LLC DBA TRANQUIL MIND COUNSELING
Entity type:Organization
Organization Name:EVANS WEISS, LLC DBA TRANQUIL MIND COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:EVANS
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-833-1555
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84055-0356
Mailing Address - Country:US
Mailing Address - Phone:801-833-1555
Mailing Address - Fax:
Practice Address - Street 1:1452 E RIVER LANE
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:UT
Practice Address - Zip Code:84055-0356
Practice Address - Country:US
Practice Address - Phone:801-833-1555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVANS WEISS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-05
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty