Kimberly L Evans, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

4239C Issued in AL

Practice address

1634 Slaughter Rd
Madison, AL 35758-5913

Phone

(256) 822-2375

Fax

(256) 584-2330

NPI assigned

Dec 3, 2007

Last updated

Jan 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• The Collective Counseling and Consulting

  • Mental Health Counselor
  • Huntsville, AL
  • NPI 1619757929
  NPD
• Mental Health Center of North Central Alabama

  • Community/Behavioral Health Agency
  • Decatur, AL
  • NPI 1780859314
  NPD (past)
• Mental Health Center of North Central Alabama Inc.

  • Community/Behavioral Health Agency
  • Decatur, AL
  • NPI 1124193636
  NPD (past)

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1033391933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 100",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-822-2375",
            "fax_number": "256-584-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 SLAUGHTER RD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585913",
            "telephone_number": "256-822-2375",
            "fax_number": "256-584-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Moulton St E",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AL",
            "postal_code": "356012310",
            "country_code": "US",
            "telephone_number": "256-822-2375",
            "fax_number": "256-584-2330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "4239C",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "4239C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Thomas Estes, OTR/L
• Schonna Maria Etheridge, CRNP
• Alison Ruth Ethridge
• Euphrates Health and Wellness Center, LLC
• Kim Evans, RN, IBCLC
• Landon Neal Evans, PT
• Maria Michelle Evans, PHARM.D.
• Everyday People Inc.
• Eyecare Associates, Inc.
• Eyecare Associates, Inc.

• Social Worker in Madison, AL
• Providers in Madison, AL by specialty
• Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.