Jessica Lynn Evancho, LCAT, ATR-BC

Primary specialty

Art TherapistTaxonomy code 221700000X

License

002056 Issued in NY

Practice address

29 W 36TH St Ste 5E
New York, NY 10018-7907

Phone

(817) 713-9088

NPI assigned

Nov 13, 2018

Last updated

Nov 24, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543017600000",
    "number": "1801365416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 W 36TH ST # 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187907",
            "telephone_number": "718-260-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 W 36TH ST STE 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187907",
            "telephone_number": "817-713-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANCHO",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "LCAT, ATR-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "002056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Art Therapist in New York, NY
• Providers in New York, NY by specialty
• Art Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.

Verify at the official NPI Registry.