Jaclyn Ann Evans
Mental Health Counselor Addiction Counselor (Substance Use Disorder)
435 E Main St
Ansonia
, Connecticut 06401-1964
Jaclyn Ann Evans
Mental Health Counselor Addiction Counselor (Substance Use Disorder)
435 E Main St
Ansonia
, Connecticut 06401-1964
(203) 736-2905
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About
Features
Specialties
- Addiction Counselor (Substance Use Disorder)
- Mental Health Counselor
Languages spoken
- English
Location
First Address
- Jaclyn Ann Evans
- Po Box 658 435 East Main Street
- Ansonia, CT
- Zip : 06401-0658
- Phone : (203) 736-2905
Second Address
- Jaclyn Ann Evans
- 435 E Main St
- Ansonia, CT
- Zip : 06401-1964
- Phone : (203) 736-2905
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
| Y | 101YM0800X | Mental Health Counselor |
National Provider Identifier
| NPI | 1003000449 |
|---|---|
| Provider Name | Jaclyn Ann Evans |
| First Address | Ansonia, CT 06401-0658 |
| Second Address | Ansonia, CT 06401-1964 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/08/2007 |
| Last Update Date | 17/09/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.