D Amanda Evans, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW13344 Issued in FL

Practice address

12590 Whitehall Dr Ste 3
Fort Myers, FL 33907-4680

Phone

(239) 939-9090

NPI assigned

Dec 15, 2015

Sex

Female

Sole proprietor

Yes

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)

Enrolled

State licenses

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1174988331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8942 ELLINGTON ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075913",
            "telephone_number": "239-691-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12590 WHITEHALL DR STE 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074680",
            "telephone_number": "239-939-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "D",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliza Lynn Evangelista
• Evans Avenue Health Care Clinic, Inc
• Evans Avenue Opco LLC
• Evans Chiropractic LLC
• Evans Health Care Associates LLC
• Tinikki Shunta Evans
• Sandra Lee Eveleth, O.D.
• Eventus Infusion LLC
• Eventus RX LLC
• Evercare Health

• Clinical Social Worker in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.