Individual provider Active NPI

Evangelin Browne

  • Marriage & Family Therapist
  • Fairfax, VA
National Provider Identifier
1881226645
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0717001415 Issued in VA
Practice address
10605 Judicial Dr Ste A1
Fairfax, VA 22030-5116
Phone
(910) 644-7883
NPI assigned
Feb 10, 2020
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717001415 VA Primary

Addresses

Primary practice location

10605 Judicial Dr Ste A1
Fairfax, VA 22030-5116

Mailing address

10605 Judicial Dr Ste A1
Fairfax, VA 22030-5116
Phone (910) 644-7883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20231221004049 FL Practitioner - Marriage and Family Therapist 5193175784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Psychological Services, PLLCGroup PAC ID 4587969977, 15 clinicians

Practice addresses (Care Compare)

205 S Hoover Blvd
Suite 202
Tampa, FL 33609-3574
Phone (813) 563-1155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0717001415VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Psychological Services PLLC CurrentSince Jan 1, 2024 Accepting new patients
Gilford Sound Emergency Physicians LLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

3637 4th St N
Ste 390
St Petersburg, FL 33704
Phone (813) 445-5268

205 S Hoover Blvd
Ste 202
Tampa, FL 33609
Phone (813) 563-1155

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1881226645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 JUDICIAL DR STE A1",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305116",
            "telephone_number": "910-644-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 JUDICIAL DR STE A1",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305116",
            "telephone_number": "910-644-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWNE",
        "first_name": "EVANGELIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.