Individual ProviderKim EvansSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1106 E 6600 S, Salt Lake City, UT 84121-2446(385) 429-8200PECOS EnrollmentBased on the most recent information from CMS, provider Kim Evans does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1902450109Provider TypeIndividualFull NameEvans, KimCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date7/26/2019Last Updated7/26/2019Contact InformationPractice LocationPractice Address1106 E 6600 S, Salt Lake City, UT 84121-2446Phone(385) 429-8200Fax(801) 327-7064Mailing LocationMailing Address206 N 2100 W, Salt Lake City, UT 84116-4740Phone(385) 429-8200FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense135154-3501UtahCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense135154-3501Utah