Jaclyn Ann Evans, PSY.D.
Individual provider Active NPI Mental Health Counselor · Ansonia, CT
NPI 1003000449 · NPPES record last updated Sep 17, 2009
Key facts
- NPI
- 1003000449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 435 E Main St
Ansonia, CT 06401-1964 - Phone
- (203) 736-2905
- NPI assigned
- Aug 29, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bhcare, Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/BHcare/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
435 E Main St
Ansonia, CT 06401-1964
Mailing address
PO Box 658
435 East Main Street
Ansonia, CT 06401-0658
Phone (203) 736-2905
Other providers in Ansonia, CT
- Kayla Duncan
- Clarvdia Dunn
- Jay L Dworkin
- Effective Healthcare Medical P.C.
- Enlightened Empaths Psychotherapy and Counseling LLC
- Nikayla Christiana Evans
- Toni Evans
- Alice Falco
- Richard Andrew Feher Jr.
- Kristina Filomena
All providers in Ansonia, CT · Mental Health Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.