Provider Demographics
NPI:1871609586
Name:LENT, EVELYN EDWARDS (LCSW)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:EDWARDS
Last Name:LENT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-6733
Mailing Address - Country:US
Mailing Address - Phone:207-786-3434
Mailing Address - Fax:207-786-3411
Practice Address - Street 1:443 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6733
Practice Address - Country:US
Practice Address - Phone:207-786-3434
Practice Address - Fax:207-786-3411
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC13821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME233700000Medicaid
ME233700000Medicaid