DR. KELLY CHARLES EVANS (NPI# 1720165251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720165251 |
| Entity Type | Individual |
| Full Name | DR. KELLY CHARLES EVANS |
| Credential | PH.D. |
| Practice Address |
2714 Stewart Ave Wausau WI 54401-4153 |
| Practice Telephone | 7158493988 |
| Practice Fax Number | 7158493988 |
| Mailing Telephone | 7158493988 |
| Mailing Fax Number | 7158493988 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
2027 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39120800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407211352 | Kelly Evans | Home Health Aide | 13947 Castille St, Victorville, CA 92392-5508 | 2015-12-19 |
| 1396178174 | Kelly Evans | Counselor | 8 Reservoir Circle, Suite 103, Families Connected, LLC, Baltimore, MD 21208 | 2013-08-15 |
| 1093027906 | Kelly Anne Evans | Marriage & Family Therapist | 408 Saint Peter St Ste 429, Saint Paul, MN 55102-1119 | 2010-07-08 |
| 1235289976 | Kelly Carter Evans | Counselor | 27888 Meadow Dr, Suite 106, Evergreen, CO 80439-2102 | 2007-01-12 |
| 1124107693 | Kelly Evans | Internal Medicine | 85 Highway 80, Manchester, KY 40962-8801 | 2006-11-03 |
| 1730654104 | Kelly Evans | Speech-Language Pathologist | 13333 Blanco Rd Ste 310, San Antonio, TX 78216-7756 | 2018-10-11 |
| 1508341181 | Kelly Evans | Nurse Practitioner | 6616 Center Grove, Edwardsville, IL 62025 | 2018-09-28 |
| 1699221663 | Kelly Ann Evans | Nurse Anesthetist, Certified Registered | 51 N 39th St, Philadelphia, PA 19104-2640 | 2016-08-30 |
| 1245785534 | Kelly Evans | Counselor | 3701 Landsdowne Dr, Ashland, KY 41102-5422 | 2016-08-17 |
| 1093024721 | Kelly L Evans | Pharmacist | 1675 Leahy St, Stuite 111, Muskegon, MI 49442-5500 | 2010-09-29 |
| Street Address |
2714 STEWART AVE |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401-4153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215146907 | Evans Counseling, LLC | Community/Behavioral Health | 2714 Stewart Ave, Wausau, WI 54401-4153 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629607619 | Eleanor Arlene Tidball | Psychologist | 13320 W Grange Ave, New Berlin, WI 53151-8131 | 2020-04-02 |
| 1134769441 | Graham Gardner Knowlton | Psychologist | Milwaukee Vamc 5000 W National Ave, Milwaukee, WI 53295-0001 | 2020-01-14 |
| 1477197929 | Samuel David Lustgarten | Psychologist | 1025 W Johnson St Rm 303b, Madison, WI 53706-1706 | 2019-10-28 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1770133555 | Kerrin Sendrowitz O'connor | Psychologist | 1509 S Outagamie St, Appleton, WI 54914-5580 | 2019-09-13 |
| 1982193546 | Samantha Jo Schwartz-oscar | Psychologist | 2809 School Rd, Greenleaf, WI 54126-9209 | 2018-05-08 |
| 1790202851 | Wisconsin Lutheran Child & Family Service | Psychologist | 2669 N Richards St, Milwaukee, WI 53212-2850 | 2017-08-29 |
| 1902337785 | Carla Mae Davey | Psychologist | 333 E Campus Mall Rm 7, University Health Services, Madison, WI 53715-1740 | 2017-03-23 |
| 1558739300 | Hayley Shilling | Psychologist | 6602 Grand Teton Plz Ste 100, Madison, WI 53719-2905 | 2015-09-10 |
| 1568850840 | Belinda Gutierrez | Psychologist | 2500 Overlook Terrace, 116b, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705-2286 | 2015-01-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.