Individual provider Active NPI

Jennifer Lorine Evans Powis, LPC

  • Counselor
  • New York, NY
National Provider Identifier
1396074654
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2009035752 Issued in MO
Practice address
2578 Broadway # 607
New York, NY 10025-5642
Phone
(516) 847-5432
NPI assigned
Dec 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2009035752 MO Primary

Addresses

Primary practice location

2578 Broadway # 607
New York, NY 10025-5642

Mailing address

2578 Broadway # 607
New York, NY 10025-5642
Phone (516) 847-5432

Other identifiers 1

IdentifierTypeStateIssuer
1396074654MedicaidMO

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2009035752MOMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1396074654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2578 BROADWAY # 607",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255642",
            "telephone_number": "516-847-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2578 BROADWAY # 607",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255642",
            "telephone_number": "516-847-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS POWIS",
        "first_name": "JENNIFER",
        "middle_name": "LORINE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-16",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2009035752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396074654",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.