Provider Demographics
NPI:1447942602
Name:EVANS, LATRINA CHARMAINE (MA)
Entity type:Individual
Prefix:
First Name:LATRINA
Middle Name:CHARMAINE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7064 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-1882
Mailing Address - Country:US
Mailing Address - Phone:412-598-4631
Mailing Address - Fax:
Practice Address - Street 1:5301 BUTLER ST STE 100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-2658
Practice Address - Country:US
Practice Address - Phone:412-441-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health