Individual provider Active NPI

Deborah K. Evans, LSCW, BCD

  • Clinical Social Worker
  • Chantilly, VA
National Provider Identifier
1457427833
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904003512 Issued in VA
Practice address
14900 Bogle Dr
Ste 200
Chantilly, VA 20151-1756
Phone
(703) 472-6056
Fax
(703) 817-9860
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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 0904003512 VA Primary

Addresses

Primary practice location

14900 Bogle Dr
Ste 200
Chantilly, VA 20151-1756

Mailing address

10540 Poagues Battery Dr
Bristow, VA 20136-1337
Phone (703) 472-6056

Other identifiers 1

IdentifierTypeStateIssuer
8908966MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 27, 2025 through Aug 27, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904003512VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Racquel Semeraro Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1457427833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10540 POAGUES BATTERY DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361337",
            "telephone_number": "703-472-6056",
            "fax_number": "703-817-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14900 BOGLE DR",
            "address_2": "STE 200",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511756",
            "telephone_number": "703-472-6056",
            "fax_number": "703-817-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DEBORAH",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "LSCW, BCD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908966",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

Verify at the official NPI Registry.