Individual provider Active NPI

Sharon Evancio, LPC

  • Professional Counselor
  • Montclair, NJ
National Provider Identifier
1215067939
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00035900 Issued in NJ
Practice address
100 Valley Rd Ste 12
Montclair, NJ 07042-2220
Phone
(973) 509-8000
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00035900 NJ Primary

Addresses

Primary practice location

100 Valley Rd Ste 12
Montclair, NJ 07042-2220

Mailing address

100 Valley Rd Ste 12
Montclair, NJ 07042-2220
Phone (973) 509-8000

Other practice location 1

35 Amboy Ave
Metuchen, NJ 08840-2578
Phone (973) 509-8000

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

LicenseStateTypeSpecialty
37PC00035900NJMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1215067939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VALLEY RD STE 12",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422220",
            "telephone_number": "973-509-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VALLEY RD STE 12",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422220",
            "telephone_number": "973-509-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Amboy Ave",
            "address_purpose": "LOCATION",
            "city": "Metuchen",
            "state": "NJ",
            "postal_code": "088402578",
            "country_code": "US",
            "telephone_number": "973-509-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANCIO",
        "first_name": "SHARON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00035900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.