Individual provider Active NPI

Nicole K Evans, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Warrensville HTS, OH
National Provider Identifier
1942086608
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.185580 Issued in OH
Practice address
4002 Warrensville Center Road
Warrensville HTS, OH 44122
Phone
(216) 561-8300
NPI assigned
Sep 7, 2023
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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 CDCA.185580 OH Primary

Addresses

Primary practice location

4002 Warrensville Center Road
Warrensville HTS, OH 44122

Mailing address

4002 Warrensville Center Road
Warrensville HTS, OH 44122
Phone (216) 561-8300

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
CDCA.185580OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1942086608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 WARRENSVILLE CENTER ROAD",
            "city": "WARRENSVILLE HTS",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-561-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 WARRENSVILLE CENTER ROAD",
            "city": "WARRENSVILLE HTS",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-561-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "NICOLE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.185580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensville HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.