Wendell Margo Maurice Evans, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RO41606-01 Issued in NY

Practice address

555 Rockaway Pkwy # 113
Brooklyn, NY 11212-3132

Phone

(718) 240-5121

Fax

(718) 240-5121

NPI assigned

Jul 17, 2024

Sex

Male

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1235977968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 OVERLOOK AVE APT 12A",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076017804",
            "telephone_number": "347-213-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 ROCKAWAY PKWY # 113",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123132",
            "telephone_number": "718-240-5121",
            "fax_number": "718-240-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "WENDELL",
        "middle_name": "MARGO MAURICE",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO41606-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shenell Evans, PHD
• Susan Evans
• Tanisha Elzeatha Evans
• Tiffany Evans
• Timothy Evans, PEER SPECIALIST
• Willie James Evans, L.P.N.
• Twila Evanson, LCSW
• Guilaine Evariste, NURSE PRACTITIONER
• Lorena Evdokimenko
• Eve 4 Pharmacy

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.