Richard Wallace Evans Jr., CRC, LPCC
Individual provider Active NPI Mental Health Counselor · Madisonville, KY
NPI 1194470575 · NPPES record last updated Jan 21, 2025
Key facts
- NPI
- 1194470575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 296010 (KY)
- Practice address
- 260 W McLaughlin Ave
Madisonville, KY 42431-3024 - Phone
- (270) 821-6426
- NPI assigned
- Feb 15, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250310001489 | KY | Practitioner - Mental Health Counselor | 9537680301 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Leaf Counseling & Coaching | Multi-Specialty | Current |
Accepting new patients |
| McCoy Counseling LLC | Counselor | Past |
Accepting new patients |
| Mental Wellness Connection | Mental Health | Past |
Accepting new patients |
Locations
260 W McLaughlin Ave
Madisonville, KY 42431
Phone (270) 821-6426
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 296010 | KY | Yes |
Addresses
Primary practice location
260 W McLaughlin Ave
Madisonville, KY 42431-3024
Mailing address
260 W McLaughlin Ave
Madisonville, KY 42431-3024
Phone (270) 821-6426
Other providers in Madisonville, KY
- Jodie R. Ellsworth
- Emily Brown Taylor PSC
- Tracey Lynn Ervin
- Jennifer Nicole Estes
- Walker Lee Estes
- Alisha B. Evitts
- William Andrew Fain
- Derek Fairrow
- Amira Faizal-Vincent
- Laura Ann Farley
All providers in Madisonville, KY · Mental Health Counselor in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.