Individual provider Active NPI

Evins Wall, LPC

  • Professional Counselor
  • Florence, AL
National Provider Identifier
1215639067
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC05934 Issued in AL
Practice address
635 W College St
Florence, AL 35630-5313
Phone
(256) 764-3431
Fax
(256) 764-3431
NPI assigned
Mar 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC05934 AL Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

635 W College St
Florence, AL 35630-5313

Mailing address

635 W College St
Florence, AL 35630-5313
Phone (256) 764-3431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20260512003537 AL Practitioner - Mental Health Counselor 7618476177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Center for Mental HealthGroup PAC ID 6507821048, 15 clinicians

Practice addresses (Care Compare)

205 Jackson Ave S
Russellville, AL 35653-2233
Phone (256) 332-3971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC05934ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Center for Mental Health CurrentSince Apr 3, 2026 Accepting new patients

Locations

635 W College St
Florence, AL 35630
Phone (256) 764-3431

205 Jackson Ave S
Russellville, AL 35653
Phone (256) 332-3971

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1215639067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W COLLEGE ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305313",
            "telephone_number": "256-764-3431",
            "fax_number": "256-764-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W COLLEGE ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305313",
            "telephone_number": "256-764-3431",
            "fax_number": "256-764-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "EVINS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "LPC05934",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.