Evan McCoy Powell, LPCA, LCASA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A11130 Issued in NC

Practice address

4140 Cherry St
Winston Salem, NC 27105-2536

Phone

(336) 306-9620

Fax

(336) 245-8839

NPI assigned

Dec 6, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Monarch

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1073267126
  NPD
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1801116405
  NPD
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1972644334
  NPD

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1174868848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 CHERRY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271052536",
            "telephone_number": "336-306-9620",
            "fax_number": "336-245-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 CHERRY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271052536",
            "telephone_number": "336-306-9620",
            "fax_number": "336-245-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "EVAN",
        "middle_name": "MCCOY",
        "name_prefix": "Mr.",
        "credential": "LPCA, LCASA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-06",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2913-A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A11130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Bradley Potts, MD
• Alex Powell
• Bayard Lowery Powell, MD
• Casey Hodgin Powell, FNP-C, RN
• Emily Caldwell Powell, P.T.
• Jaiden Brooke Powell, PTA
• Jason Allen Powell, MD
• Jennifer Winn Powell, FNP-BC
• Jerry Lamon Powell, MD
• Michele Denise Powell, D.O.

• Professional Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.