Active NPI
Nicole Evans
- Mental Health Counselor
- Seattle, WA
National Provider Identifier
1104527951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC61218700
- Practice address
- 312 N 85TH St # 102
Seattle, WA 98103-3659 - Phone
- (360) 768-4851
- NPI assigned
- Mar 16, 2023
- Sex
- Female
- 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 | MC61218700 | WA | Primary |
Addresses
Primary practice location
312 N 85TH St # 102
Seattle, WA 98103-3659
Mailing address
312 N 85TH St # 102
Seattle, WA 98103-3659
Phone (206) 552-9652
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 |
|---|---|---|---|
| MC61218700 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709856000000",
"number": "1104527951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 N 85TH ST # 102",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981033659",
"telephone_number": "206-552-9652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 N 85TH ST # 102",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981033659",
"telephone_number": "360-768-4851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-16",
"last_updated": "2024-03-08",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC61218700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.