MRS. AMY NICOLE EVERMON M.S.ED
NPI 1962488783
Counselor in Mattoon, IL

Q: What is Amy Evermon's NPI number?

The NPI number for Amy Evermon is 1962488783. It was assigned to this individual provider in the NPPES registry on December 22, 2005. The provider is also known as Miss Amy Nicole Brault M.S.Ed.

Q: What is Amy Evermon's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Amy Evermon was last updated on November 21, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 22, 2005PECOS EnrolledAccepts Medicare Assignment

750 BROADWAY AVE E, MATTOON, IL 61938(217) 238-5700(217) 238-5767 Get Directions Write a Review

NPPES record last updated: November 21, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mrs. Amy Nicole Evermon M.s.ed NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. AMY NICOLE EVERMON M.S.ED (NPI 1962488783) is an individual counselor in Mattoon, Illinois and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1962488783

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameMRS. AMY NICOLE EVERMONCredential: M.S.ED

Location Address750 BROADWAY AVE EMattoon, IL 61938-4610

Mailing Address750 Broadway Ave EMattoon, IL 61938-4610 · (217) 238-5700 · Fax (217) 238-5767

Phone(217) 238-5700

Fax(217) 238-5767

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateDecember 22, 2005

Last NPPES UpdateNovember 21, 2007

✔ NPI 1962488783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

750 BROADWAY AVE E, Mattoon, IL 61938

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Other Names 1

Former Name (1)Miss Amy Nicole Brault M.s.ed

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Amy Nicole Evermon M.s.ed is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244676815

PECOS Enrollment IDI20240306002262

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIAYA LOY MS, MHP

Counselor