Courtney Tara Evans, PHD, LCM HC-S, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

S-11202 Issued in NC

Practice address

718 Washington Street
Eden, NC 27288

Phone

(336) 613-8351

NPI assigned

Jun 15, 2015

Last updated

Jan 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Courtney Tara Thompson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: courtneyevans@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  Counselor

  NPD

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1326429416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 GLEN OAK DRIVE",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "27288",
            "telephone_number": "336-613-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 WASHINGTON STREET",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "27288",
            "telephone_number": "336-613-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "COURTNEY",
        "middle_name": "TARA",
        "name_prefix": "Mrs.",
        "credential": "PHD, LCM HC-S, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A11202",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "S-11202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "THOMPSON",
            "middle_name": "TARA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Counselor in Eden, NC
• Providers in Eden, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.