Samuel Ray Evans, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC002604 Issued in GA

Practice address

1135 Cedar Shoals Dr Ste B
Athens, GA 30605-5299

Phone

(706) 549-5522

Fax

(888) 267-4454

NPI assigned

Aug 20, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1396225298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 CRESTWOOD DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053913",
            "telephone_number": "706-549-5523",
            "fax_number": "888-267-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 CEDAR SHOALS DR STE B",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306055299",
            "telephone_number": "706-549-5522",
            "fax_number": "888-267-4454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3735 Harrison Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300528895",
            "country_code": "US",
            "telephone_number": "770-466-7374",
            "fax_number": "888-267-4454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SAMUEL",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC002604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Brooks Evans, MD
• Centrael T Evans, MD
• Jaclyn Evans, PSYD
• Jeni F Evans, ATC
• Jenny Rose Evans, LCSW
• Taylor Evans, PHD, LCSW
• William A Evans, AGACNP-BC
• Melissa Evers, OTR/L
• Evirtualcare, LLC
• Kathryn Ewing

• Professional Counselor in Athens, GA
• Providers in Athens, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.