Individual provider Active NPI

Allison Christine Evans, LPC

  • Mental Health Counselor
  • Roswell, GA
National Provider Identifier
1720472111
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC011104 Issued in GA
Practice address
401 Bombay LN
Roswell, GA 30076-5826
Phone
(704) 664-1920
NPI assigned
Mar 24, 2015
Last updated
Oct 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A11532 NC
Mental Health Counselor 101YM0800X 11532 NC
Mental Health Counselor 101YM0800X LPC011104 GA Primary

Addresses

Primary practice location

401 Bombay LN
Roswell, GA 30076-5826

Mailing address

3361 E Hencart Rd
Glennville, GA 30427-3208
Phone (910) 391-2297

Other practice location 1

5710 Oleander Dr
Suite 208
Wilmington, NC 28403-4766
Phone (910) 452-1460

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

State licenses

LicenseStateTypeSpecialty
LPC011104GAMDMental Health Counselor
11532NCMDMental Health Counselor
A11532NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1720472111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 E HENCART RD",
            "city": "GLENNVILLE",
            "state": "GA",
            "postal_code": "304273208",
            "telephone_number": "910-391-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765826",
            "telephone_number": "704-664-1920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5710 Oleander Dr",
            "address_2": "Suite 208",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284034766",
            "country_code": "US",
            "telephone_number": "910-452-1460",
            "fax_number": "910-397-0821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ALLISON",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A11532",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "11532",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC011104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.