Active NPI
Mechele De Avila Evans, LCSW
- Clinical Social Worker
- Baton Rouge, LA
National Provider Identifier
1124087481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 40065
- Practice address
- 1082 Havenwood Drive
Back Apartment
Baton Rouge, LA 70815-6730 - Phone
- (225) 366-8606
- Fax
- (225) 410-0080
- NPI assigned
- Mar 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 40065 | LA | Primary |
Addresses
Primary practice location
1082 Havenwood Drive
Back Apartment
Baton Rouge, LA 70815-6730
Mailing address
PO Box 41001
Baton Rouge, LA 70835
Phone (225) 366-8606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1549495 | Medicaid | LA |
Other names 1
- Ms. Mechele Elizabeth De Avila
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 |
|---|---|---|---|
| 4065 | LA | MD | Counselor |
| 40065 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson Parish Human Services Authority | Past | Accepting new patients | |
| Jefferson Parish Human Services Authority | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jefferson, LA
- NPI 1194252478
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Marrero, LA
- NPI 1821039983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1124087481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 41001",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70835",
"telephone_number": "225-366-8606",
"fax_number": "225-410-0080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1082 HAVENWOOD DRIVE",
"address_2": "BACK APARTMENT",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708156730",
"telephone_number": "225-366-8606",
"fax_number": "225-410-0080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "MECHELE",
"middle_name": "DE AVILA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-23",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "40065",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1549495",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MECHELE",
"last_name": "DE AVILA",
"middle_name": "ELIZABETH",
"prefix": "MS.",
"credential": "LCSSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.