Evan Waldman, LCMHC

Key facts

NPI

1760029474

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

License

068.0065445 (VT)

Practice address

275 VT 15 W
Johnson, VT 05656-9657

Phone

(802) 585-0703

NPI assigned

Dec 2, 2019

Sex

Male

Sole proprietor

Yes

Organizations & group practices 3

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.

• Howard Center Inc Developmentally Disabled Services Day Training Agency · Burlington, VT · NPI 1639267404
  Medicare reassignment NPD VT
• Howard Center Inc Methadone Clinic · Burlington, VT · NPI 1134346687
  NPD
• Howard Center Inc Developmentally Disabled Services Day Training Agency · Burlington, VT · NPI 1770700221
  NPD

Medicare Care Compare profile

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 29, 2025.

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1760029474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SMUGGLERS VIEW RD",
            "city": "JEFFERSONVILLE",
            "state": "VT",
            "postal_code": "054649507",
            "telephone_number": "802-730-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 VT 15 W",
            "city": "JOHNSON",
            "state": "VT",
            "postal_code": "056569657",
            "telephone_number": "802-585-0703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1138 Pine St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054015353",
            "country_code": "US",
            "telephone_number": "802-488-6000",
            "fax_number": "802-488-6919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "EVAN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-02",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VT",
            "license": "068.0065445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson, VT

• Barbara Lillian Rosenthal, M.D.
• Rose Ruane
• Liza Bieron Ryan, LICSW
• Matthew Sadowsky, MA
• Margaret R Sladyk-Benoit, MSW, LICSW

All providers in Johnson, VT · Professional Counselor in Vermont