Active NPI
Shannon Nilaja Evans, LPCC-S
- Professional Counselor
- Columbus, OH
National Provider Identifier
1194767004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.0004314-SUPV
- Practice address
- 1180 E Main St
Columbus, OH 43205-1902 - Phone
- (614) 645-5535
- Fax
- (614) 645-5546
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.0004314-SUPV | OH | Primary |
Addresses
Primary practice location
1180 E Main St
Columbus, OH 43205-1902
Mailing address
1800 Watermark Dr
Suite 420
Columbus, OH 43215-1048
Phone (614) 645-5500
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 |
|---|---|---|---|
| E.0004314-SUPV | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441324800000",
"number": "1194767004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 WATERMARK DR",
"address_2": "SUITE 420",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432151048",
"telephone_number": "614-645-5500",
"fax_number": "614-645-5517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 E MAIN ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432051902",
"telephone_number": "614-645-5535",
"fax_number": "614-645-5546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "SHANNON",
"middle_name": "NILAJA",
"credential": "LPCC-S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2015-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.0004314-SUPV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.