Individual provider Active NPI

Kristen M Evans, LCPC

  • Professional Counselor
  • Oakland, MD
National Provider Identifier
1376106542
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC9804 Issued in MD
Practice address
1025 Memorial Dr
Oakland, MD 21550-4343
Phone
(301) 334-7680
Fax
(301) 334-7685
NPI assigned
Apr 15, 2019
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC9804 MD Primary
School Counselor 101YS0200X LGP8094 MD

Addresses

Primary practice location

1025 Memorial Dr
Oakland, MD 21550-4343

Mailing address

1025 Memorial Dr
Oakland, MD 21550-4343
Phone (301) 334-7680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC9804MDMDProfessional Counselor
LGP8094MDMDSchool Counselor

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1376106542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MEMORIAL DR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215504343",
            "telephone_number": "301-334-7680",
            "fax_number": "301-334-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MEMORIAL DR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215504343",
            "telephone_number": "301-334-7680",
            "fax_number": "301-334-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC9804",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MD",
            "license": "LGP8094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

Verify at the official NPI Registry.