Provider Demographics
NPI:1447496302
Name:NAVARRO, EVANGELINA (MA, LPC)
Entity type:Individual
Prefix:
First Name:EVANGELINA
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MRS
Other - First Name:EVANGELINA
Other - Middle Name:N
Other - Last Name:GREINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1368 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:BITELY
Mailing Address - State:MI
Mailing Address - Zip Code:49309-9207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 W WOOD ST
Practice Address - Street 2:
Practice Address - City:NEWAYGO
Practice Address - State:MI
Practice Address - Zip Code:49337-8991
Practice Address - Country:US
Practice Address - Phone:231-206-6519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011044101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional