Marilyn Evans, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC3424 Issued in MD

Practice address

10515 Theodore Green Blvd
White Plains, MD 20695-3042

Phone

(301) 873-4593

Fax

(301) 753-1919

NPI assigned

Mar 17, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Intact Counseling Service, LLC

  • Community/Behavioral Health Agency
  • White Plains, MD
  • NPI 1386968600
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1013231265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 THEODORE GREEN BLVD",
            "address_2": "SUITE 214",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953042",
            "telephone_number": "301-885-9760",
            "fax_number": "301-753-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10515 THEODORE GREEN BLVD",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953042",
            "telephone_number": "301-873-4593",
            "fax_number": "301-753-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MARILYN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036797400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Dube, CRNP
• Boma Fabia Ehanire, LCSW-C
• Mfon Ekanem
• Lisa Elder
• Nathan Kenneth Elliott, P.T.
• Everside Health Ua Plumbers Local 5 White Plains
• Evora Health Group
• Dalia A Fadul, M.D.
• Fairview Uro Center LLC
• Family First Psychotherapy Services LLC

• Professional Counselor in White Plains, MD
• Providers in White Plains, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.