Active NPI
Evan James Maclusky, M.A.
- Professional Counselor
- Carbondale, PA
National Provider Identifier
1104277524
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective Dec 20, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC009013
- Practice address
- 30-32 N Main St
Carbondale, PA 18407-2304 - Phone
- (570) 282-1732
- Fax
- (570) 282-6805
- NPI assigned
- Jun 27, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC009013 | PA | Primary |
Addresses
Primary practice location
30-32 N Main St
Carbondale, PA 18407-2304
Mailing address
30-32 N Main St
Carbondale, PA 18407-2304
Phone (570) 282-1732
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC009013 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1104277524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30-32 N MAIN ST",
"city": "CARBONDALE",
"state": "PA",
"postal_code": "184072304",
"telephone_number": "570-282-1732",
"fax_number": "570-282-6805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30-32 N MAIN ST",
"city": "CARBONDALE",
"state": "PA",
"postal_code": "184072304",
"telephone_number": "570-282-1732",
"fax_number": "570-282-6805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACLUSKY",
"first_name": "EVAN",
"middle_name": "JAMES",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-27",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC009013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carbondale, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.