Provider Demographics
NPI:1184916504
Name:EVANS, KRISTEN LEIGH (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LEIGH
Last Name:EVANS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 CASSIDY DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8091
Mailing Address - Country:US
Mailing Address - Phone:910-338-8558
Mailing Address - Fax:
Practice Address - Street 1:525 NORTH TRYON STREET
Practice Address - Street 2:SUITE 1600
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-4010
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2025-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2590103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst