Individual provider Active NPI

Evelyn Cecilia Wadsworth, LCSW

  • Clinical Social Worker
  • Alexandria, VA
National Provider Identifier
1245302686
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904000784 Issued in VA
Practice address
4318 Caprice Court
Alexandria, VA 22310
Phone
(703) 960-7610
Fax
(703) 960-7610
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904000784 VA Primary

Addresses

Primary practice location

4318 Caprice Court
Alexandria, VA 22310

Mailing address

4318 Caprice Court
Alexandria, VA 22310
Phone (703) 960-7610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2016 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904000784VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245302686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 CAPRICE COURT",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22310",
            "telephone_number": "703-960-7610",
            "fax_number": "703-960-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 CAPRICE COURT",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22310",
            "telephone_number": "703-960-7610",
            "fax_number": "703-960-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "EVELYN",
        "middle_name": "CECILIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.