Individual provider Active NPI

Selina Joy Popovich-Evans, LMSW,CACII

  • Addiction (Substance Use Disorder) Counselor
  • Valdosta, GA
National Provider Identifier
1356430193
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1735 Issued in GA
Practice address
3120 N Oak Street Ext
Suite C
Valdosta, GA 31602-1007
Phone
(229) 386-3537
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1735 GA Primary
Social Worker 104100000X MSW004127 GA

Addresses

Primary practice location

3120 N Oak Street Ext
Suite C
Valdosta, GA 31602-1007

Mailing address

4877 Union Rd
Tifton, GA 31794-8536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1735GAMDAddiction (Substance Use Disorder) Counselor
MSW004127GAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1356430193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4877 UNION RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317948536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 N OAK STREET EXT",
            "address_2": "SUITE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021007",
            "telephone_number": "229-386-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPOVICH-EVANS",
        "first_name": "SELINA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "LMSW,CACII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "1735",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW004127",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.