Active NPI
Judith Kathleen Evans, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1982615936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 16944
- Practice address
- 2707 Airport Fwy
Fort Worth, TX 76111-2370 - Phone
- (817) 480-8703
- NPI assigned
- Aug 11, 2006
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 16944 | TX | Primary |
Addresses
Primary practice location
2707 Airport Fwy
Fort Worth, TX 76111-2370
Mailing address
112 Valley View Dr N
Colleyville, TX 76034-3209
Phone (817) 480-8703
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1671521 | Medicaid | TX |
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 |
|---|---|---|---|
| 16944 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982615936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 VALLEY VIEW DR N",
"city": "COLLEYVILLE",
"state": "TX",
"postal_code": "760343209",
"telephone_number": "817-480-8703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2707 AIRPORT FWY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761112370",
"telephone_number": "817-480-8703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "JUDITH",
"middle_name": "KATHLEEN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "16944",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1671521",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.