Evans, Larry

Evans, Larry is an individual health care provider with primary practice located at 1654 E Union St , Greenville MS 38703-3250. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Evans, Larry can be contacted via phone (662) 335-5274.

Contact Information

Primary practice address
1654 E Union St Greenville MS 38703-3250
Phone: (662) 335-5274
Fax: (662) 378-3976
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1699959437
LBN Legal business name Evans, Larry
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2007
Last updated Dec 27th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699959437 NPPES
Mississippi MEDICAID 0018205

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