Kenya Racquel Evans, QMHS, STNA
Individual provider Active NPI Case Manager/Care Coordinator · Lakemore, OH
NPI 1477834760 · NPPES record last updated Feb 15, 2024
Key facts
- NPI
- 1477834760
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1266 Main St # 818
Lakemore, OH 44250-9801 - Phone
- (330) 805-5568
- NPI assigned
- Aug 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | |||
| Behavior Technician | 106S00000X | |||
| Case Manager/Care Coordinator | 171M00000X | OH | Yes |
Addresses
Primary practice location
1266 Main St # 818
Lakemore, OH 44250-9801
Mailing address
PO Box 818
Lakemore, OH 44250-0818
Phone (330) 805-5568
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2910854 | Medicaid | OH |
Other providers in Lakemore, OH
- Mark Anthony Barnes
- Corinna Croskey
- H and M Home Improvements Inc.
- Qutie and the Beards
- Village of Lakemore
- Carolyn Watson
- Sharon Denise Wilson
All providers in Lakemore, OH · Case Manager/Care Coordinator in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.