Elaine Marjorie Evans, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-17219 Issued in AZ

Practice address

2060 W Whispering Wind Dr Ste 270
Phoenix, AZ 85085-2869

Phone

(480) 653-8434

NPI assigned

Jan 15, 2020

Sex

Female

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

Opted out of Medicare

Yes, effective Feb 17, 2026 through Feb 17, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Third Place Therapy LLC

  • Counselor
  • Phoenix, AZ
  • NPI 1477361558
  NPD Authorized official
• Phoenix Wellness Center LLC

  • Mental Health Counselor
  • Phoenix, AZ
  • NPI 1720572043
  NPD
• Phoenix Wellness Center

  • Mental Health Counselor
  • Phoenix, AZ
  • NPI 1194232512
  NPD (past)

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1295375517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 W WHISPERING WIND DR STE 270",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850852869",
            "telephone_number": "480-653-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 W WHISPERING WIND DR STE 270",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850852869",
            "telephone_number": "480-653-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ELAINE",
        "middle_name": "MARJORIE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-17219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Evans, MSN,APRN, AGACNP-BC
• Charles Wilson Evans, MASSAGE THERAPIST
• Charlotte Evans
• Claire Marie Evans, FNP
• Edward Evans, MD
• Elise Evans
• Elizabeth Margaret Evans
• Emily Evans, PHARMD
• Evan David Evans, PA-C
• Janet Evans, PNP

• Mental Health Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.