Active NPI
Shanna Evering, LCPC
- Professional Counselor
- Columbia, MD
National Provider Identifier
1427401199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC3763
- Practice address
- 10715 Charter Dr Ste 130
Columbia, MD 21044-2892 - Phone
- (443) 653-1363
- Fax
- (410) 367-2000
- NPI assigned
- Jul 19, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC3763 | MD | Primary |
Addresses
Primary practice location
10715 Charter Dr Ste 130
Columbia, MD 21044-2892
Mailing address
10715 Charter Dr Ste 130
Columbia, MD 21044-2892
Phone (443) 653-1363
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Columbia |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC3763 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Discover Yourself Wellness Center, LLC | Current | Accepting new patients | |
| Bluegrass Mental Health | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Columbia, MD
- NPI 1720507940
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Columbia, MD
- NPI 1639561384
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632355200000",
"number": "1427401199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10715 CHARTER DR STE 130",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210442892",
"telephone_number": "443-653-1363",
"fax_number": "410-367-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10715 CHARTER DR STE 130",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210442892",
"telephone_number": "443-653-1363",
"fax_number": "410-367-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERING",
"first_name": "SHANNA",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-19",
"last_updated": "2021-09-23",
"certification_date": "2021-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC3763",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Columbia",
"affiliation": "N",
"endpointDescription": "Columbia",
"address_1": "10715 Charter Dr Ste 130",
"city": "Columbia",
"state": "MD",
"country_code": "US",
"postal_code": "210442892",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.