Active NPI
Matthew H Evoy Jr., CDP, CCC
- Addiction (Substance Use Disorder) Counselor
- Bellingham, WA
National Provider Identifier
1942576020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CP00004951
- Practice address
- 1130 N State St
Bellingham, WA 98225-5014 - Phone
- (360) 676-4485
- Fax
- (360) 714-1294
- NPI assigned
- Mar 22, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP00004951 | WA | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CL60160856 | WA |
Addresses
Primary practice location
1130 N State St
Bellingham, WA 98225-5014
Mailing address
1130 N State St
Bellingham, WA 98225-5014
Phone (360) 676-4485
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
| License | State | Type | Specialty |
|---|---|---|---|
| CL60160856 | WA | MD | Addiction (Substance Use Disorder) Counselor |
| CP00004951 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332374400000",
"number": "1942576020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 N STATE ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982255014",
"telephone_number": "360-676-4485",
"fax_number": "360-714-1294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 N STATE ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982255014",
"telephone_number": "360-676-4485",
"fax_number": "360-714-1294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVOY",
"first_name": "MATTHEW",
"middle_name": "H",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "CDP, CCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-22",
"last_updated": "2012-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP00004951",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CL60160856",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
- Evergreen at Bellingham, L.L.C.
- Evergreen Community & Support Services LLC
- Evergreen North Cascades Health & Rehab Ctr.
- Evergreen Psychiatry, LLC
- Evergreen Supported Living
- Jeannette Marie Evraets, RN LAC
- Lucinda Ewing, RN
- Excel Physical Therapy Inc.
- Expanding Visions Counseling PLLC
- Eyeco Optometry PS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.