Andrea Dawn Evans, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

128894 Issued in KY

Practice address

1740 Central Ave
Ashland, KY 41101-7653

Phone

(606) 585-7897

Fax

(833) 922-1959

NPI assigned

May 27, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1649227448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 MCCULLOUGH ST",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411024450",
            "telephone_number": "606-585-7897",
            "fax_number": "833-922-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 CENTRAL AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017653",
            "telephone_number": "606-585-7897",
            "fax_number": "833-922-1959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 WINCHESTER AVE",
            "address_purpose": "LOCATION",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411011962",
            "country_code": "US",
            "telephone_number": "606-329-9333",
            "fax_number": "606-329-0468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 McCullough St",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411024450",
            "country_code": "US",
            "telephone_number": "606-585-7897",
            "fax_number": "833-922-1959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ANDREA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "128894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0920801",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2527555",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY BOARD OF EXAMINERS OF PSYCHOLOGY",
            "identifier": "128894",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Ashland, KY
• Providers in Ashland, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.