Individual provider Active NPI

Avin Anvaripour, LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1194392662
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34010754A Issued in IN
Practice address
60 S Stockwell Rd
Evansville, IN 47714-0247
Phone
(812) 476-5437
Fax
(812) 436-4316
NPI assigned
Jun 4, 2021
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 99104665A IN
Social Worker 104100000X 33010333A IN
Clinical Social Worker 1041C0700X 34010754A IN Primary

Addresses

Primary practice location

60 S Stockwell Rd
Evansville, IN 47714-0247

Mailing address

530 Bentee Wes Court
Evansville, IN 47715
Phone (812) 401-1836

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
33010333AINMDSocial Worker
99104665AINMDSocial Worker
34010754AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Counseling LLC Clinical CurrentSince Oct 22, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1194392662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 BENTEE WES COURT",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47715",
            "telephone_number": "812-401-1836",
            "fax_number": "124-018-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 S STOCKWELL RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140247",
            "telephone_number": "812-476-5437",
            "fax_number": "812-436-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANVARIPOUR",
        "first_name": "AVIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "99104665A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33010333A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010754A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.