Provider Demographics
NPI:1578660130
Name:SANDERS, EVELYN (MSW)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 PEACH ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-8304
Mailing Address - Country:US
Mailing Address - Phone:919-894-5399
Mailing Address - Fax:
Practice Address - Street 1:2034 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-2429
Practice Address - Country:US
Practice Address - Phone:919-231-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC001682OtherCLINICAL SOCIAL WORK