Alyssa Ann Evett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.024296 Issued in IL

Practice address

2000 W Pioneer Pkwy Ste 14
Peoria, IL 61615-1882

Phone

(309) 550-1001

Fax

(309) 322-6470

NPI assigned

May 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Bloom Therapy Studio

  • Clinical Social Worker
  • Morton, IL
  • NPI 1669319380
  NPD
• Full Circle Counseling and Wellness, LLC

  • Professional Counselor
  • Peoria, IL
  • NPI 1558976209
  NPD

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1154067213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W PIONEER PKWY STE 14",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151882",
            "telephone_number": "309-550-1001",
            "fax_number": "309-322-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W PIONEER PKWY STE 14",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151882",
            "telephone_number": "309-550-1001",
            "fax_number": "309-322-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVETT",
        "first_name": "ALYSSA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Andrew Evans, M.D.
• Steven R Evelhoch, MD
• Sonja G Evens, LCSW
• Monica Everett, PA-C
• Everside Health, LLC
• Penelope A Ewbank, MD
• Diane Ewers, CRNA
• Extended Pharmacy LLC
• Stephen J Eyler, MD
• Mark O Fabish, PHYSICAL THERAPIST

• Clinical Social Worker in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.

Verify at the official NPI Registry.