Active NPI
Lynda G Evans, LCSW
- Clinical Social Worker
- Gainesville, FL
National Provider Identifier
1114130622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 5366
- Practice address
- 4300 SW 13TH St
Attn: HR Department
Gainesville, FL 32608-4006 - Phone
- (352) 374-5600
- Fax
- (352) 374-5608
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 5366 | FL | Primary |
Addresses
Primary practice location
4300 SW 13TH St
Attn: HR Department
Gainesville, FL 32608-4006
Mailing address
4300 SW 13TH St
Attn: HR Department
Gainesville, FL 32608-4006
Phone (352) 374-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 761685600 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 5366 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270684800000",
"number": "1114130622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 SW 13TH ST",
"address_2": "ATTN: HR DEPARTMENT",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326084006",
"telephone_number": "352-374-5600",
"fax_number": "352-374-5608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 SW 13TH ST",
"address_2": "ATTN: HR DEPARTMENT",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326084006",
"telephone_number": "352-374-5600",
"fax_number": "352-374-5608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "LYNDA",
"middle_name": "G",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2010-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 5366",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "761685600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.