Evans Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2027 Issued in WI

Legal business name

EVANS COUNSELING, LLC

Practice address

2714 Stewart Ave
Wausau, WI 54401-4153

Phone

(715) 849-3988

Fax

(715) 849-5838

NPI assigned

May 21, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Charles Evans, PH.D.NPI 1720165251

Title

Licensed Psychologist, Owner

Phone

(715) 849-3988

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Charles Evans, PH.D.

  • Counseling Psychologist
  • Wausau, WI
  • NPI 1720165251
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215146907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014153",
            "telephone_number": "715-849-3988",
            "fax_number": "715-849-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014153",
            "telephone_number": "715-849-3988",
            "fax_number": "715-849-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST, OWNER",
        "authorized_official_telephone_number": "715-849-3988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "2027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39120800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Filagot Debebe Eshete, MD
• Emmanuel Esianor, PHYSICIAN ASSISTANT
• Jesse T Espe, DPT
• McKinley Kealani Espindabanick
• Kimberly J. Esterline, LCSW
• Kelly Charles Evans, PH.D.
• Lori M Evans
• Zjia Anita Manzanares Evans, C.R.N.A.
• Stephanie L Eversdyk, CMA
• Evolve Counseling LLC

• Community/Behavioral Health Agency in Wausau, WI
• Providers in Wausau, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.