Evan Michael Lafountain

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

805 Liberty St NE Ste 2
Salem, OR 97301-2463

Phone

(219) 669-8267

NPI assigned

Jun 29, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Evergreen Counseling and Consultation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilsonville, OR
  • NPI 1295629806
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1285204511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2822 WALNUT CT",
            "city": "HUBBARD",
            "state": "OR",
            "postal_code": "970329692",
            "telephone_number": "219-669-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 LIBERTY ST NE STE 2",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012463",
            "telephone_number": "219-669-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFOUNTAIN",
        "first_name": "EVAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erik@empoweringchoicescc.com",
            "affiliation": "N",
            "endpointDescription": "Email of Counseling Supervisor",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "805 Liberty St NE Ste 2",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973012463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jaunda Ladd, PSS
• Ladies First Choice Inc
• Laura Ladue, LAC
• Lydia Chung Laffitte
• Irene M Laflair-Sexton, RN
• Cheryl Mishaleigh Canlas Lagman, RDH
• Lags Spine and Sportscare Medical Centers, Inc.
• Michael Louis Laharty, M.S. C.D.S. III
• Frank Gibson Lahman, PH.D.
• Martin Bruce Lahr, M.D., M.P.H.

• Mental Health Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.