Evelyn G Edwards, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

043739 Issued in NY

Practice address

1490 William Floyd Parkway
East Yaphank, NY 11967

Phone

(631) 924-3741

NPI assigned

May 1, 2007

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548481302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 KETTLES LANE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "11763",
            "telephone_number": "631-732-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 WILLIAM FLOYD PARKWAY",
            "city": "EAST YAPHANK",
            "state": "NY",
            "postal_code": "11967",
            "telephone_number": "631-924-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "EVELYN",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "043739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Bridget Costantino, M.A., CCC-SLP
• Elizabeth P Degrocco, LCSW-R
• Thomas M Doxsee, MSOTR/L
• Joanne Duran, LAC,LMT,LPN
• Eastern Li Speech Pathology &Swallowing Disorders PC
• Family Counseling Services
• Janez Francis
• Doreen Lorraine Fratello, LMSW
• Tomas Gonzalez, LCSW-R
• Jennifer M Hovestadt-Molloy, MS CCC-SLP

• Clinical Social Worker in East Yaphank, NY
• Providers in East Yaphank, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.