Jessica Dawn Evans, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.0900294 Issued in OH

Practice address

3130 N County Road 25a
Troy, OH 45373

Phone

(937) 440-7626

Fax

(937) 440-7702

NPI assigned

Mar 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uvpc Specialists, Inc.Group PAC ID 8921022260, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Uvpc Specialists Inc.

  • Surgery Physician
  • Troy, OH
  • NPI 1831115492
  Medicare reassignment Care Compare group NPD
• Uvpc Specialists, Inc.

  • Orthopaedic Surgery Physician
  • Troy, OH
  • NPI 1699911446
  NPD

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1588058994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD. BLDG. B",
            "address_2": "THIRD FLOOR",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3188",
            "fax_number": "937-223-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "45373",
            "telephone_number": "937-440-7626",
            "fax_number": "937-440-7702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 S Dixie Dr Ste 260",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454091542",
            "country_code": "US",
            "telephone_number": "937-853-9061 x1203",
            "fax_number": "937-853-9069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2555 S Dixie Dr Ste 260",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454091542",
            "country_code": "US",
            "telephone_number": "937-853-9061 x1203",
            "fax_number": "937-853-9069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 N County Road 25A",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "45373",
            "country_code": "US",
            "telephone_number": "937-991-3188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JESSICA",
        "middle_name": "DAWN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0900294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0240332",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kendall Erdahl, MD
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• Faith Ventures, LLC
• Amanda Falldorf, NP
• Nicolas Max Farenwald, DO
• Kim Renee Feeny, R.N.

• Mental Health Counselor in Troy, OH
• Providers in Troy, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.