Krystal Evola, LLMSW
Individual provider Active NPI Clinical Social Worker · Washington Township, MI
NPI 1164110698 · NPPES record last updated Apr 24, 2023
Key facts
- NPI
- 1164110698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 60005 Campground Rd Ste 400
Washington Township, MI 48094-3446 - Phone
- (586) 604-7776
- NPI assigned
- Apr 24, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
418 W Frank St
Caro, MI 48723-1408
60005 Campground Rd
Suite 400
Washington, MI 48094-3445
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260206000953 | MI | Practitioner - Clinical Social Worker | 0446739890 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Katrina Motrinc, LLC | Clinical | Current |
Accepting new patients |
Locations
60005 Campground Rd
Ste 400
Washington Twp, MI 48094
Phone (248) 219-1109
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MI | Yes |
Addresses
Primary practice location
60005 Campground Rd Ste 400
Washington Township, MI 48094-3446
Mailing address
60005 Campground Rd
Washington Township, MI 48094-3445
Phone (586) 232-5089
Other providers in Washington Township, MI
- Leah Michelle Jenkins Cecil
- Companion Care Services Inc.
- Christopher Czapp
- Nicole Ellen Dolan
- Jillian Alysse Doss
- Flourish Therapeutic Services, PLLC
- Omar Francis
- David M Genoff
- Linda Lee Habrowski
- Matthew James Jerore
All providers in Washington Township, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.