Jennie Evans, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC010831 Issued in GA

Practice address

1631 Gordon Hwy Ste 17a
Augusta, GA 30906-2229

Phone

(706) 230-7006

Fax

(762) 257-7442

NPI assigned

Oct 4, 2019

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennie.evans.1@25899.direct.athenahealth.com

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.

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  • NPI 1588090229
  Medicare reassignment NPD
• Lifesource of North Carolina

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  • Rome, GA
  • NPI 1962940817
  Medicare reassignment NPD
• Lifesource of North Carolina

  • Psychologist
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  • NPI 1730648288
  NPD

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1720629298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740015",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 GORDON HWY STE 17A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062229",
            "telephone_number": "706-230-7006",
            "fax_number": "762-257-7442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Boland Cir",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "GA",
            "postal_code": "310872007",
            "country_code": "US",
            "telephone_number": "706-444-1037",
            "fax_number": "706-444-1034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1263 Moreland Ave SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303163183",
            "country_code": "US",
            "telephone_number": "470-444-3137",
            "fax_number": "470-202-3003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JENNIE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evans Eye Care
• Alexis Evans
• Carla Marshelle Evans, MSM
• Denise Rae Evans, M.D.
• Donald Durrell Evans, MD
• John Willis Evans, D.O.
• Mary Leann Evans, PHARMD
• Natalie Evans, DMD
• Shandrice Evans, RN
• Tyler Lee Evans, D.O.

• Professional Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.