Active NPI
Kristen Evans, MA
- Counselor
- Anderson, IN
National Provider Identifier
1669994828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 88000412A
- Practice address
- 2010 Brentwood Dr
Anderson, IN 46011-4042 - Phone
- (765) 393-0063
- Fax
- (765) 393-3761
- NPI assigned
- Jul 10, 2017
- Last updated
- Nov 29, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 88000412A | IN | Primary |
Addresses
Primary practice location
2010 Brentwood Dr
Anderson, IN 46011-4042
Mailing address
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 254-5184
Other practice location 1
3620 W White River Blvd
Muncie, IN 47304-4286
Phone (765) 288-1928
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88000412A | IN | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Health Services Corp. | Past | Accepting new patients | |
| Meridian Health Services Corp | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Muncie, IN
- NPI 1992755490
-
- Federally Qualified Health Center (FQHC)
- Montpelier, IN
- NPI 1417838574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543449600000",
"number": "1669994828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 N TILLOTSON AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043988",
"telephone_number": "765-254-5184",
"fax_number": "765-741-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 BRENTWOOD DR",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460114042",
"telephone_number": "765-393-0063",
"fax_number": "765-393-3761"
}
],
"practiceLocations": [
{
"address_1": "3620 W White River Blvd",
"address_purpose": "LOCATION",
"city": "Muncie",
"state": "IN",
"postal_code": "473044286",
"country_code": "US",
"telephone_number": "765-288-1928",
"fax_number": "765-288-2032",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS",
"first_name": "KRISTEN",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-10",
"last_updated": "2018-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IN",
"license": "88000412A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.