| Ms Jennie Evans, LPC | |
|
1631 Gordon Hwy Ste 17a, Augusta, GA 30906-2229 | |
| (706) 230-7006 | |
| (762) 257-7442 |
| Full Name | Ms Jennie Evans |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1631 Gordon Hwy Ste 17a, Augusta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720629298 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC010831 (Georgia) | Primary |
| Entity Name | Lifesource Of North Carolina |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962940817 PECOS PAC ID: 7416132428 Enrollment ID: O20170418000863 |
| Entity Name | Oak Street Health Of Georgia Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588258024 PECOS PAC ID: 0345658647 Enrollment ID: O20210427001330 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Jennie Evans, LPC Po Box 740015, Atlanta, GA 30374-0015 Ph: (312) 733-9730 | Ms Jennie Evans, LPC 1631 Gordon Hwy Ste 17a, Augusta, GA 30906-2229 Ph: (706) 230-7006 |
Whitney O'connor, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1232 Hickman Rd, Augusta, GA 30904 Phone: 678-414-4596 | |
Danny Robinson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2609 Commons Boulevard, Augusta, GA 30909 Phone: 706-843-6242 | |
Ms. Jaime Penn, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2226 Acapulco Dr Apt C, Augusta, GA 30906 Phone: 706-750-9442 | |
Monifa Mccarther, Counselor Medicare: Medicare Enrolled Practice Location: 2101 Central Ave, Augusta, GA 30904 Phone: 706-750-2809 Fax: 706-868-5023 | |
Mr. Robert Derek Yosen, CAC2 Counselor Medicare: Not Enrolled in Medicare Practice Location: 2357 Tobacco Rd, Augusta, GA 30906 Phone: 706-722-3855 Fax: 706-798-3795 | |
Jennifer Diane Watson, APC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3421 Mike Padgett Hwy, Augusta, GA 30906 Phone: 706-432-7893 Fax: 706-432-3780 | |
Ms. Stephanie D Grant, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 3540 Wheeler Rd, Suite 619, Augusta, GA 30909 Phone: 706-733-0333 Fax: 706-733-0313 |