Evan Thomas Groomer
Individual provider Active NPI Professional Counselor · New Orleans, LA
NPI 1336770734 · NPPES record last updated Dec 26, 2022
Key facts
- NPI
- 1336770734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 7925 (LA)
- Practice address
- 4150 Earhart Blvd
New Orleans, LA 70125-1955 - Phone
- (504) 522-4475
- NPI assigned
- Feb 4, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240504000306 | LA | Practitioner - Mental Health Counselor | 0547600702 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Addiction Counseling and Educational Resources, LLC | Current |
Accepting new patients | |
| Addiction Counseling and Educational Resources, LLC | Current |
Accepting new patients | |
| Addiction Counseling and Educational Resources, LLC | Past | Accepting new patients |
Locations
4430 S I 10 Service Rd W
Ste 100
Metairie, LA 70001
Phone (504) 941-7580
2321 N Hullen St
Ste B
Metairie, LA 70001
Phone (504) 885-4327
115 Christian Ln
Slidell, LA 70458
Phone (985) 690-6622
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7925 | LA | Yes |
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
Other providers in New Orleans, LA
- Ashara Grimes
- Margaret Mary Grimsley
- Robert L Grinstead
- Bryan Benjamin Grissett
- Chelsea S Grobe
- Chassidy Jovan Groover
- Grosbeak Emergency Physicians LLC
- Sara Jane Gross
- Shalise Gross
- Wadeja Gross
All providers in New Orleans, LA · Professional Counselor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.