Provider Demographics
NPI:1861382467
Name:LESCALLETTE, EVAN (MA, LPC)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:LESCALLETTE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 BELGRADE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-3801
Mailing Address - Country:US
Mailing Address - Phone:717-418-5892
Mailing Address - Fax:
Practice Address - Street 1:1335 E CHOCOLATE AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1117
Practice Address - Country:US
Practice Address - Phone:717-606-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA018868101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional