Patricia J Evans, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801062680 Issued in MI

Practice address

2092 S Custer Rd
Monroe, MI 48161-1831

Phone

(734) 242-8711

Fax

(734) 242-3955

NPI assigned

Oct 18, 2006

Last updated

May 8, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Masterpeace Center for Counseling & Development

  dba Masterpeace Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tecumseh, MI
  • NPI 1366773368
  NPD (past)
• Masterpeace Center for Counseling & Development

  dba Masterpeace Counseling

  • Psychologist
  • Tecumseh, MI
  • NPI 1780899286
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1356422042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 LUCERNE DR",
            "address_2": "SUITE 405",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441306588",
            "telephone_number": "440-234-8833",
            "fax_number": "440-234-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2092 S CUSTER RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481611831",
            "telephone_number": "734-242-8711",
            "fax_number": "734-242-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801062680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386460149",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenedie Etts
• Lea S Etts, PC
• Amanda Kay Eubanks
• Emily Evans
• Jammie Lynn Evans, LPN
• Family Counseling & Shelter Services
• Family Counseling and Shelter Services of Monroe County
• Family Medical Center of Michigan (Family Medical Center of Mi-Monroe II)
• Family Medical Center of Michigan, Inc (Family Medical Center of Michigan, Inc- Waterloo)
• Family Medical Center of Michigan, Inc

• Clinical Social Worker in Monroe, MI
• Providers in Monroe, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.