Evan Robert Hathaway, MS, LCGC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

000397 Issued in PA

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Phone

(215) 590-2920

NPI assigned

Jan 30, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1255839817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 N FRONT ST APT A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191061302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "EVAN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MS, LCGC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-30",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "PA",
            "license": "000397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Hatcher
• Rami Hatem
• Kaitlin Blum Hatfield, LPC
• Brynn Hathaway, MD
• Elizabeth Hathaway, CCC-SLP
• Alexandra Hathorn
• Emily M Hatke, DO
• Claire Hatkevich, PHD
• Hats in Homecare LLC
• Alyssa Hatsukami

• Genetic Counselor (M.S.) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Genetic Counselor (M.S.) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.