Victoria Evangelista

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401019743 Issued in MI

Practice address

6548 Town Center Dr Ste D
Clarkston, MI 48346-4823

Phone

(586) 244-8052

NPI assigned

Feb 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/pimsy-thrive

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.

• Thrive Behavioral Health

  • Clinical Psychologist
  • Shelby Township, MI
  • NPI 1245667443
  Medicare reassignment NPD
• Hope in Counseling, Inc.

  • Community/Behavioral Health Agency
  • Sterling Heights, MI
  • NPI 1316318850
  NPD (past)
• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1326439399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1697 CARDIFF ROW",
            "city": "SUPERIOR TOWNSHIP",
            "state": "MI",
            "postal_code": "481983587",
            "telephone_number": "586-244-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6548 TOWN CENTER DR STE D",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464823",
            "telephone_number": "586-244-8052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Lansing Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492021621",
            "country_code": "US",
            "telephone_number": "517-784-2929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017276",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401019743",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401019743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YA0400X",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326439399",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Engelman
• Darcy Thomas England, CADC
• Lois Epperson, RN
• Erika Marie- Schleis Essenmacher, OT
• Haley Erin Estes
• Amanda Evanoff
• Leeanne Evanoff
• Evergreen Health Services, Inc.
• Evergreen Home Health Care LLC
• Evergreen Personal Services, LLC

• Counselor in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.