Evans, Jerome C
Evans, Jerome C is an sole proprietor health care provider with primary practice located at 1300 Dixie Ln S , Saint Petersburg FL 33707-3914. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Evans, Jerome C can be contacted via phone (727) 823-5555.Contact Information
Primary practice address
1300 Dixie Ln S
Saint Petersburg FL 33707-3914
Phone: (727) 823-5555
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW2478 | Florida |
Profile Details
| NPI number | 1679592661 |
|---|---|
| LBN Legal business name | Evans, Jerome C |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Nov 14th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679592661 | NPPES |
| Florida | Other | Z3918A | BX |
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