Active NPI
Carolyn B Evans, LCSW
- Clinical Social Worker
- Boulder, CO
National Provider Identifier
1194957274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1180
- Practice address
- 1221 Pearl St Ste 13
Boulder, CO 80302 - Phone
- (720) 260-2901
- NPI assigned
- Aug 21, 2009
- 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 | 1180 | CO | Primary |
Addresses
Primary practice location
1221 Pearl St Ste 13
Boulder, CO 80302
Mailing address
PO Box 3346
Nederland, CO 80466-3301
Phone (720) 260-2901
Other practice location 1
20 Lakeview Dr
#204
Nederland, CO 80466
Phone (720) 260-2901
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1180 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carrie B Evans LTD | Clinical | Past | 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 and National Provider Directory roles.
-
- Clinical Social Worker
- Nederland, CO
- NPI 1871079764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527811200000",
"number": "1194957274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3346",
"city": "NEDERLAND",
"state": "CO",
"postal_code": "804663301",
"telephone_number": "720-260-2901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 PEARL ST STE 13",
"city": "BOULDER",
"state": "CO",
"postal_code": "80302",
"telephone_number": "720-260-2901"
}
],
"practiceLocations": [
{
"address_1": "20 Lakeview Dr",
"address_2": "#204",
"address_purpose": "LOCATION",
"city": "Nederland",
"state": "CO",
"postal_code": "80466",
"country_code": "US",
"telephone_number": "720-260-2901",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS",
"first_name": "CAROLYN",
"middle_name": "B",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-21",
"last_updated": "2018-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "1180",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.