Evan John Lima, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60969939 Issued in WA

Practice address

1930 Black Lake Blvd SW Ste 102
Olympia, WA 98512-5651

Phone

(360) 347-6172

NPI assigned

Feb 17, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Evergreen Psychological Services

  • Clinical Neuropsychologist
  • Olympia, WA
  • NPI 1184376048
  NPD Authorized official
• Richard P. Brooks, Jr., Arnp, Inc.

  • Psychiatric/Mental Health Registered Nurse
  • Hoquiam, WA
  • NPI 1659914000
  NPD (past)

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1821237744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BLACK LAKE BLVD SW STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985125651",
            "telephone_number": "360-347-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 BLACK LAKE BLVD SW STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985125651",
            "telephone_number": "360-347-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMA",
        "first_name": "EVAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-17",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60969939",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC60063415",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY60969939",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "PY60969939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillie McCatty, LMHC
• Lilly Denture Center, Inc
• Lilly Road Family Dentistry
• Jennah Rae Lilly
• Kenneth Paul Lim, D.D.S.
• Lincare Inc.
• Bruce Lincoln, MD
• Kim Cheri Lincoln, O.B.
• Daniel Lindberg
• Mary Lindberg, RPH

• Clinical Psychologist in Olympia, WA
• Providers in Olympia, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.