LADAWN NICHELLE EVANS


Address: 2180 44th St Se, Grand Rapids, MI 49508
Phone: 6162392299

LADAWN NICHELLE EVANS (NPI# 1568947240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568947240
Entity Type Individual
Full Name LADAWN NICHELLE EVANS
Credential MA, LLPC
Practice Address 2180 44th St Se
Grand Rapids
MI 49508
Mailing Address 2180 44th St Se
Grand Rapids
MI 49508-5323
Practice Telephone 6162392299
Mailing Telephone 6162392299
Enumeration Date 2018-09-28
Last Update Date 2019-06-25
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
6401017336 MI Behavioral Health & Social Service Providers
N 171M00000X Case Manager/Care Coordinator Other Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
3300 36th St Se, Grand Rapids, MI 495122810 6169427294
2180 44th St Se, Grand Rapids, MI 49508 6162392299

Office Location

Street Address 2180 44TH ST SE
City GRAND RAPIDS
State MI
Zip Code 49508

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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1104488105 Travis Gordon Counselor 800 Monroe Ave Nw Ste 319, Grand Rapids, MI 49503-1451 2019-07-01
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Competitor

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City GRAND RAPIDS
Zip Code 49508

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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