Individual provider Active NPI

Jessica Evans, LPC

  • Counselor
  • Charleston, SC
National Provider Identifier
1639880206
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
8587 Issued in SC
Practice address
21 Gamecock Ave Ste E
Charleston, SC 29407-3368
Phone
(843) 212-6293
NPI assigned
Dec 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 8587 SC Primary

Addresses

Primary practice location

21 Gamecock Ave Ste E
Charleston, SC 29407-3368

Mailing address

1608 Camp Rd Ste 79
Charleston, SC 29412-4012
Phone (843) 212-6293

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steadfast Christian Counseling, LLC CurrentSince Jun 18, 2023 Accepting new patients

Locations

21 Gamecock Ave
Ste E
Charleston, SC 29407
Phone (843) 417-0817

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.

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1639880206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 CAMP RD STE 79",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124012",
            "telephone_number": "843-212-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GAMECOCK AVE STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073368",
            "telephone_number": "843-212-6293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "8587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.