NPIMap

Individual provider Active NPI

Evelina Jabaay

  • Counselor
  • Ann Arbor, MI
National Provider Identifier
1629339759
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6301014956 Issued in MI
Practice address
2890 Carpenter Rd
Suite 1600
Ann Arbor, MI 48108-1100
Phone
(734) 677-0609
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6301014956 MI Primary

Addresses

Primary practice location

2890 Carpenter Rd
Suite 1600
Ann Arbor, MI 48108-1100

Mailing address

2890 Carpenter Rd
Suite 1600
Ann Arbor, MI 48108-1100
Phone (734) 677-0609

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Counseling, PLLC Past Accepting new patients
Samaritan Counseling Services Past Accepting new patients
Samaritan Counseling Center of Southeastern Michigan Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1629339759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 CARPENTER RD",
            "address_2": "SUITE 1600",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081100",
            "telephone_number": "734-677-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 CARPENTER RD",
            "address_2": "SUITE 1600",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081100",
            "telephone_number": "734-677-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABAAY",
        "first_name": "EVELINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6301014956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.