Carol Anne Evangelisto
Individual provider Active NPI Professional Counselor · Allentown, NJ
NPI 1043716236 · NPPES record last updated Apr 5, 2018
Key facts
- NPI
- 1043716236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 37PC00135300 (NJ)
- Practice address
- 3 S Main St
Allentown, NJ 08501-1683 - Phone
- (609) 208-3053
- NPI assigned
- Apr 5, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00135300 | NJ | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00135300 | NJ | Yes |
Addresses
Primary practice location
3 S Main St
Allentown, NJ 08501-1683
Mailing address
16 Hilton CT
Pennington, NJ 08534-1959
Phone (609) 730-9422
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All providers in Allentown, NJ · Professional Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2018. 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.