Active NPI
Kaneisha S Evans, LCMHC
- Mental Health Counselor
- Durham, NC
National Provider Identifier
1700617644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 20209
- Practice address
- 2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273 - Phone
- (833) 532-7553
- NPI assigned
- Aug 12, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-30196 | NC | |
| Mental Health Counselor | 101YM0800X | 20209 | NC | Primary |
Addresses
Primary practice location
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Mailing address
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Phone (833) 532-7552
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS-30196 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 20209 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaleidoscope Dream Center PLLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
Locations
2530 Meridian Pkwy
Ste 300
Durham, NC 27713
Phone (919) 443-1708
Interoperability endpoints
- kaneisha.evans.p1@direct.bdihs.nextgenshare.com
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.
-
- Community/Behavioral Health Agency
- Durham, NC
- NPI 1124996335
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1700617644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2530 MERIDIAN PKWY STE 300",
"city": "DURHAM",
"state": "NC",
"postal_code": "277135273",
"telephone_number": "833-532-7552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2530 MERIDIAN PKWY STE 300",
"city": "DURHAM",
"state": "NC",
"postal_code": "277135273",
"telephone_number": "833-532-7553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "KANEISHA",
"middle_name": "S",
"credential": "LCMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-12",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-30196",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "20209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.