Individual provider Active NPI

Evelyn Zavala

  • Addiction (Substance Use Disorder) Counselor
  • Roswell, NM
National Provider Identifier
1912674128
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CSA0218211 Issued in NM
Practice address
72 Gail Harris St
Roswell, NM 88203-8116
Phone
(575) 347-3400
NPI assigned
Aug 25, 2021
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CSA0218211 NM Primary

Addresses

Primary practice location

72 Gail Harris St
Roswell, NM 88203-8116

Mailing address

2904 Diamond a Dr
Roswell, NM 88201-3417
Phone (575) 937-6332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSA0218211NMMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1912674128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 DIAMOND A DR",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013417",
            "telephone_number": "575-937-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 GAIL HARRIS ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882038116",
            "telephone_number": "575-347-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVALA",
        "first_name": "EVELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0218211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.