Dwight Daniel Evans, MA, M.DIV., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC004180 Issued in PA

Practice address

133 Switzgabel Dr
Brodheadsville, PA 18322-7120

Phone

(570) 401-6378

NPI assigned

Jul 29, 2010

Last updated

May 26, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1316251549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 IOWA RD",
            "city": "ALBRIGHTSVILLE",
            "state": "PA",
            "postal_code": "182103622",
            "telephone_number": "570-401-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 SWITZGABEL DR",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183227120",
            "telephone_number": "570-401-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DWIGHT",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MA, M.DIV., LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC004180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Brodheadsville, PA
• Providers in Brodheadsville, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.