Active NPI
Justin Dewayne Evans I
- Mental Health Counselor
- Natchitoches, LA
National Provider Identifier
1104365097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 820 Gentry Davis
Natchitoches, LA 71457 - Phone
- (318) 946-6073
- NPI assigned
- Feb 13, 2017
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LA | Primary |
Addresses
Primary practice location
820 Gentry Davis
Natchitoches, LA 71457
Mailing address
820 Gentry Davis St
Natchitoches, LA 71457-3762
Phone (318) 946-6073
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486944000000",
"number": "1104365097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 GENTRY DAVIS ST",
"city": "NATCHITOCHES",
"state": "LA",
"postal_code": "714573762",
"telephone_number": "318-946-6073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 GENTRY DAVIS",
"city": "NATCHITOCHES",
"state": "LA",
"postal_code": "71457",
"telephone_number": "318-946-6073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "JUSTIN",
"middle_name": "DEWAYNE",
"name_prefix": "Mr.",
"name_suffix": "I",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-13",
"last_updated": "2017-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Natchitoches, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.