Individual provider Active NPI

Laurie Evans, LCSW

  • Counselor
  • Chattanooga, TN
National Provider Identifier
1063619963
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LSW0000004473 Issued in TN
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

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
34003522AINMDMental Health Counselor
CSW003778TNMDMental Health Counselor
LSW0000004473TNMDMental Health Counselor
CSW003778GAMDMarriage & Family Therapist
4473TNMDPharmacist

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

Verify at the official NPI Registry.