Active NPI
Laurie Evans, LCSW
- Counselor
- Chattanooga, TN
National Provider Identifier
1063619963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LSW0000004473
- Practice address
- 118 Lee Parkway Dr Ste 470
Chattanooga, TN 37421-1761 - Phone
- (423) 762-1126
- NPI assigned
- Jul 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CSW003778 | GA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LSW0000004473 | TN | |
| Mental Health Counselor | 101YM0800X | LSW0000004473 | TN | |
| Mental Health Counselor | 101YM0800X | CSW003778 | TN | |
| Mental Health Counselor | 101YM0800X | 34003522A | IN | |
| Professional Counselor | 101YP2500X | LSW0000004473 | TN | |
| Professional Counselor | 101YP2500X | CSW003778 | GA | |
| Clinical Social Worker | 1041C0700X | LSW0000004473 | TN | |
| Clinical Social Worker | 1041C0700X | CSW003778 | GA | |
| Clinical Social Worker | 1041C0700X | 34003522A | IN | |
| School Social Worker | 1041S0200X | LSW0000004473 | TN | |
| School Social Worker | 1041S0200X | CSW003778 | GA | |
| Marriage & Family Therapist | 106H00000X | LSW0000004473 | TN | |
| Marriage & Family Therapist | 106H00000X | CSW003778 | GA | |
| Counselor | 101Y00000X | LSW0000004473 | TN | Primary |
Addresses
Primary practice location
118 Lee Parkway Dr Ste 470
Chattanooga, TN 37421-1761
Mailing address
PO Box 25001
Chattanooga, TN 37422-5001
Phone (423) 762-1126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080115000082 | TN | Practitioner - Clinical Social Worker | 1052492212 | Practice locations: Chattanooga, TN |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
118 Lee Pkwy Dr
Suite 470
Chattanooga, TN 37421-1761
Phone (423) 762-1126
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34003522A | IN | MD | Mental Health Counselor |
| CSW003778 | TN | MD | Mental Health Counselor |
| LSW0000004473 | TN | MD | Mental Health Counselor |
| CSW003778 | GA | MD | Marriage & Family Therapist |
| 4473 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635984000000",
"number": "1063619963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25001",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374225001",
"telephone_number": "423-762-1126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 LEE PARKWAY DR STE 470",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374211761",
"telephone_number": "423-762-1126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "LAURIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-02",
"last_updated": "2021-11-04",
"certification_date": "2021-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "CSW003778",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TN",
"license": "LSW0000004473",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TN",
"license": "LSW0000004473",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TN",
"license": "CSW003778",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "34003522A",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "LSW0000004473",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "CSW003778",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "LSW0000004473",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW003778",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34003522A",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "TN",
"license": "LSW0000004473",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "GA",
"license": "CSW003778",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "LSW0000004473",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "CSW003778",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TN",
"license": "LSW0000004473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.