Active NPI
Evelyn Zoecklein, LCMHC
- Mental Health Counselor
- Randolph, VT
National Provider Identifier
1922165489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 068-0000607
- Practice address
- 11 S Main St
Randolph, VT 05060-1330 - Phone
- (802) 728-4466
- Fax
- (802) 728-4197
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 068-0000607 | VT | Primary |
Addresses
Primary practice location
11 S Main St
Randolph, VT 05060-1330
Mailing address
240 Smith Rd
Moretown, VT 05660-9217
Phone (802) 496-4865
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1009898 | Medicaid | VT | |
| 2163465 | Other | VT | CIGNA |
| 59560 | Other | VT | BLUE CROSS |
| 14Y001580VT01 | Other | VT | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 30, 2025 through Dec 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068-0000607 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565654400000",
"number": "1922165489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 SMITH RD",
"city": "MORETOWN",
"state": "VT",
"postal_code": "056609217",
"telephone_number": "802-496-4865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 S MAIN ST",
"city": "RANDOLPH",
"state": "VT",
"postal_code": "050601330",
"telephone_number": "802-728-4466",
"fax_number": "802-728-4197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZOECKLEIN",
"first_name": "EVELYN",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2019-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068-0000607",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009898",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2163465",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "59560",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "14Y001580VT01",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Randolph, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.