Healthcare Provider Details

I. General information

NPI: 1881922995
Provider Name (Legal Business Name): KIMBERLY HINTON EVANS MA, ED.M, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2009
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KILDAIRE PARK DR STE 402
CARY NC
27518-8144
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100 SUITE 3
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 855-501-1004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00011168
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS7541
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7541
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: