Evca, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EVCA, LLC

Practice address

5355 Newberry St
Wayne, MI 48184-2305

Phone

(313) 207-3057

NPI assigned

Oct 5, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Evette N Carroll, LMSW

Title

Owner/Chief Executive Officer

Phone

(313) 207-3057

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1114689379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5355 NEWBERRY ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842305",
            "telephone_number": "313-207-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5355 NEWBERRY ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842305",
            "telephone_number": "313-207-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVCA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "EVETTE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "313-207-3057",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerald Epelman
• Destiny R Epps, RN
• Kevin Erb
• Nicole Estrada-Schafer
• Melani Mari Evalt, LLBSW
• Omowunmi Fagbamila, NP
• Fairfield Pediatrics PLLC
• Chawki M Fakih
• Tracey Lynn Falletich
• Ali Ahmad Farhat, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Wayne, MI
• Providers in Wayne, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.