Individual provider Active NPI

Evan Thomas Groomer

  • Professional Counselor
  • New Orleans, LA
National Provider Identifier
1336770734
Registry record updated Dec 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7925 Issued in LA
Practice address
4150 Earhart Blvd
New Orleans, LA 70125-1955
Phone
(504) 522-4475
NPI assigned
Feb 4, 2020
Last updated
Dec 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7925 LA Primary

Addresses

Primary practice location

4150 Earhart Blvd
New Orleans, LA 70125-1955

Mailing address

4150 Earhart Blvd
New Orleans, LA 70125-1955
Phone (504) 522-4475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20240504000306 LA Practitioner - Mental Health Counselor 0547600702 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7925LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Addiction Counseling and Educational Resources, LLC CurrentSince Apr 16, 2024 Accepting new patients
Addiction Counseling and Educational Resources, LLC CurrentSince Apr 16, 2024 Accepting new patients
Addiction Counseling and Educational Resources, LLC Past Accepting new patients
Addiction Counseling and Educational Resources, LLC PastSince Apr 16, 2024 Accepting new patients

Locations

2321 N Hullen St
Ste B
Metairie, LA 70001
Phone (504) 885-4327

4430 S I 10 Service Rd W
Ste 100
Metairie, LA 70001
Phone (504) 941-7580

115 Christian Ln
Slidell, LA 70458
Phone (985) 690-6622

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1336770734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 EARHART BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701251955",
            "telephone_number": "504-522-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 EARHART BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701251955",
            "telephone_number": "504-522-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOMER",
        "first_name": "EVAN",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "7925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.