Active NPI
Amy Michelle Evans-Gean, L.P.C.
- Counselor
- Tyler, TX
National Provider Identifier
1538487541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 64157
- Practice address
- 4713 Troup Hwy
Tyler, TX 75703-2354 - Phone
- (903) 581-7542
- NPI assigned
- May 14, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 64157 | TX | |
| Professional Counselor | 101YP2500X | 64157 | TX | |
| Counselor | 101Y00000X | 64157 | TX | Primary |
Addresses
Primary practice location
4713 Troup Hwy
Tyler, TX 75703-2354
Mailing address
304 Willow Rd
Bullard, TX 75757-5024
Phone (903) 521-0268
Other practice location 1
304 Willow Rd
Bullard, TX 75757-5024
Phone (903) 521-0268
Other names 1
- Amy Michelle Wilson
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 |
|---|---|---|---|
| 64157 | TX | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Texas Center for Independent Living | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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 Counselor
- Tyler, TX
- NPI 1285807958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1538487541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 WILLOW RD",
"city": "BULLARD",
"state": "TX",
"postal_code": "757575024",
"telephone_number": "903-521-0268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4713 TROUP HWY",
"city": "TYLER",
"state": "TX",
"postal_code": "757032354",
"telephone_number": "903-581-7542"
}
],
"practiceLocations": [
{
"address_1": "304 Willow Rd",
"address_purpose": "LOCATION",
"city": "Bullard",
"state": "TX",
"postal_code": "757575024",
"country_code": "US",
"telephone_number": "903-521-0268",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS-GEAN",
"first_name": "AMY",
"middle_name": "MICHELLE",
"credential": "L.P.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-14",
"last_updated": "2023-02-10",
"certification_date": "2023-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "64157",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "64157",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "64157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "WILSON",
"middle_name": "MICHELLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.