Individual provider Active NPI

Makia Janila Evans, LLPC

  • Mental Health Counselor
  • Detroit, MI
National Provider Identifier
1215631783
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451022163 Issued in MI
Practice address
1501 Virginia Park St
Detroit, MI 48206-2479
Phone
(313) 477-0716
NPI assigned
Mar 29, 2023
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451022163 MI Primary

Addresses

Primary practice location

1501 Virginia Park St
Detroit, MI 48206-2479

Mailing address

1501 Virginia Park St
Detroit, MI 48206-2479
Phone (313) 477-0716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260513000298 MI Practitioner - Mental Health Counselor 8325517915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1501 Virginia Park St
Detroit, MI 48206-2479

34441 8 Mile Rd
Suite 116
Livonia, MI 48152-4013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451022163MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Professional Counseling, P.C. Mental Health PastSince May 4, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1215631783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 VIRGINIA PARK ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482062479",
            "telephone_number": "313-477-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 VIRGINIA PARK ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482062479",
            "telephone_number": "313-477-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MAKIA",
        "middle_name": "JANILA",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451022163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.