Active NPI
Genevieve Rosetta Evans, LCMHCA
- Mental Health Counselor
- Jacksonville, NC
National Provider Identifier
1093540593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A20425
- Practice address
- 2424 Commerce Rd
Jacksonville, NC 28546-7505 - Phone
- (252) 557-0444
- NPI assigned
- Sep 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A20425 | NC | MD | Mental Health Counselor |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A20425 | NC | Primary |
Addresses
Primary practice location
2424 Commerce Rd
Jacksonville, NC 28546-7505
Mailing address
2424 Commerce Rd
Jacksonville, NC 28546-7505
Phone (252) 557-0444
NPI Registry JSON
{
"created_epoch": "1725408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1093540593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2424 COMMERCE RD",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285467505",
"telephone_number": "252-557-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 COMMERCE RD",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285467505",
"telephone_number": "252-557-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "GENEVIEVE",
"middle_name": "ROSETTA",
"name_prefix": "Miss",
"credential": "LCMHCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-04",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A20425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.