Individual provider Active NPI

John B Evans, PH.D., LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1235329236
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09923278 Issued in CO
Practice address
6915 Tutt Blvd Ste 110B
Colorado Springs, CO 80923-3591
Phone
(719) 445-1292
Fax
(719) 591-6486
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 27844 TX
Clinical Social Worker 1041C0700X CSW.09923278 CO Primary

Addresses

Primary practice location

6915 Tutt Blvd Ste 110B
Colorado Springs, CO 80923-3591

Mailing address

1065 NE 125TH St Ste 409
North Miami, FL 33161-5834
Phone (888) 852-6672

Other practice location 1

9218 Kimmer Dr Ste 200
Lone Tree, CO 80124-6733
Phone (303) 683-5620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Dream Catcher Therapy Center Inc. CurrentSince May 3, 2020 Accepting new patients
Thedrjohn Com LLC Clinical CurrentSince Jun 4, 2023 Accepting new patients
Hope Dealers of Grand Junction, LLC PastSince May 3, 2020 Accepting new patients

Organizations & group practices 3

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1235329236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 NE 125TH ST STE 409",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615834",
            "telephone_number": "888-852-6672",
            "fax_number": "305-891-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 TUTT BLVD STE 110B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809233591",
            "telephone_number": "719-445-1292",
            "fax_number": "719-591-6486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9218 Kimmer Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801246733",
            "country_code": "US",
            "telephone_number": "303-683-5620",
            "fax_number": "303-683-5609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "27844",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.