Individual provider Active NPI

Evan Kotler, LCSW MA

  • Clinical Social Worker
  • Boca Raton, FL
National Provider Identifier
1538899679
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW20049 Issued in FL
Practice address
200 E Royal Palm Rd Apt 406
Boca Raton, FL 33432-5035
Phone
(561) 886-8202
NPI assigned
Jun 13, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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 SW20049 FL Primary

Addresses

Primary practice location

200 E Royal Palm Rd Apt 406
Boca Raton, FL 33432-5035

Mailing address

200 E Royal Palm Rd Apt 406
Boca Raton, FL 33432-5035
Phone (561) 886-8202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SW20049FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1538899679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E ROYAL PALM RD APT 406",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334325035",
            "telephone_number": "561-886-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E ROYAL PALM RD APT 406",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334325035",
            "telephone_number": "561-886-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLER",
        "first_name": "EVAN",
        "credential": "LCSW MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.