Active NPI
Chanda Everhart, LCSW-C
- Clinical Social Worker
- Waldorf, MD
National Provider Identifier
1225626880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 23758
- Practice address
- 15901 Sharpersville Rd
Waldorf, MD 20601-3704 - Phone
- (240) 532-2195
- NPI assigned
- Jan 8, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC200001488 | DC | |
| Clinical Social Worker | 1041C0700X | 23758 | MD | Primary |
Addresses
Primary practice location
15901 Sharpersville Rd
Waldorf, MD 20601-3704
Mailing address
15901 Sharpersville Rd
Waldorf, MD 20601-3704
Phone (240) 532-2195
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220429000837 | MD | Practitioner - Clinical Social Worker | 3375930977 | Practice locations: Waldorf, MD |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC200001488 | DC | MD | Clinical Social Worker |
| 23758 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653609600000",
"number": "1225626880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15901 SHARPERSVILLE RD",
"city": "WALDORF",
"state": "MD",
"postal_code": "206013704",
"telephone_number": "240-532-2195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15901 SHARPERSVILLE RD",
"city": "WALDORF",
"state": "MD",
"postal_code": "206013704",
"telephone_number": "240-532-2195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERHART",
"first_name": "CHANDA",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-08",
"last_updated": "2022-05-27",
"certification_date": "2022-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC200001488",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "23758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
- Jonvoana Rotresh Evans
- Robert L Evans III, PHD, LCPC, LPC, MAC,
- Samantha Marie Evans
- Everbloom Psychiatric and Mental Health Services
- Rebekah Everett, LAT, ATC
- Eversafe Home Care LLC
- Excelsis Medical Supplies Corp
- Exquisite Health Solutions,LLC
- Eye Deal Vision Center, LLC.
- Eze Family Health Center, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.