Provider Demographics
NPI:1134014798
Name:EVANS, HEATHER R (LMSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:EVANS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2928 DARTMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-4607
Mailing Address - Country:US
Mailing Address - Phone:989-513-8309
Mailing Address - Fax:
Practice Address - Street 1:1205 E WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7035
Practice Address - Country:US
Practice Address - Phone:989-832-9161
Practice Address - Fax:989-832-8813
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010768041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical