Stephanie Evans, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16883 Issued in FL

Practice address

3280 Mitchell Blvd
Moody AFB, GA 31699-1580

Phone

(229) 257-2778

NPI assigned

Apr 25, 2017

Last updated

Jun 13, 2024By 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 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Florida Counseling Solutions LLC

  • Mental Health Counselor
  • Lakeland, FL
  • NPI 1477172971
  NPD Authorized official
• Stephanie Evans LLC

  • Community/Behavioral Health Agency
  • Tampa, FL
  • NPI 1316497241
  Authorized official Same address or phone
• Hedera Counseling Center

  • Mental Health Counselor
  • Moody AFB, GA
  • NPI 1083296610
  NPD

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1477088631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4937 US HIGHWAY 98 N # 9101",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093610",
            "telephone_number": "813-527-8976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 MITCHELL BLVD",
            "city": "MOODY AFB",
            "state": "GA",
            "postal_code": "316991580",
            "telephone_number": "229-257-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8910 N Dale Mabry Hwy Ste 2",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336141580",
            "country_code": "US",
            "telephone_number": "813-527-8976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "STEPHANIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW16883",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16883",
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "FL",
            "license": "SW16883",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112077100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neysa Marie Etienne, PSY.D.
• Steven Etienne, IDMT
• Logan Ryan Featherston, DO
• Adam J Fewox, IDMT
• Laura Cosima Flumerfelt, LCSW
• Steven Fogger, M.D.
• Chun Chung Fong, IDMT

• Clinical Social Worker in Moody AFB, GA
• Providers in Moody AFB, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.