Provider Demographics
NPI:1447062179
Name:EVANS, KATHERINE (NCC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 MARIETTA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3650
Mailing Address - Country:US
Mailing Address - Phone:813-624-6472
Mailing Address - Fax:
Practice Address - Street 1:4000 OLYMPIA CIR STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3614
Practice Address - Country:US
Practice Address - Phone:434-202-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health