Evelyn Junghyun Anastos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C017565 Issued in NC

Practice address

612 Ridgeline Dr Unit 221
Fort Mill, SC 29708-9463

Phone

(732) 754-0434

NPI assigned

Oct 29, 2018

Reactivated

May 20, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolinas Medical Center

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333

  NC

  Medicare reassignment NPD
• Carolinas Medical Center

  • Child & Adolescent Psychiatry Physician
  • Charlotte, NC
  • NPI 1356689996
  NPD
• Carolinas Medical Center

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1073080974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 RIDGELINE DR UNIT 221",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297089463",
            "telephone_number": "732-754-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 RIDGELINE DR UNIT 221",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297089463",
            "telephone_number": "732-754-0434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 W 66th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100236305",
            "country_code": "US",
            "telephone_number": "732-754-0434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANASTOS",
        "first_name": "EVELYN",
        "middle_name": "JUNGHYUN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "deactivation_date": "2020-05-05",
        "reactivation_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092278",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "17136",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Align America SC, LLC
• Brionna Allen, PT, DPT
• Deborah L Allen, CRNP
• Chidera Sharon Amilo, DMD
• Kwasi Kemnu Amponsa
• Anchor Therapy and Emotional Wellness, LLC
• Anderson Counseling and Education
• Alisha Nicole Anderson-Dillon, CRNA
• Amy Anderson, LPCA
• Charlotte Joan Anderson

• All providers in Fort Mill, SC
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.