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Contact Information

CLEA C EVANS, PHD
1350 E WOODROW WILSON AVE
JACKSON, MS39216-5112
 Phone: 601-981-2611
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Neuropsychologist

103G00000X
Indicates primary specialty

NPI Profile & details for CLEA C EVANS · (Female)

NPI Number 1942359096
Status Active
Credentials PHD
Entity Individual
Enumeration date 01/09/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • MS License # 41-679
  • MS Medicaid 01355624
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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