Individual provider Active NPI

Emily Anne Evans, LCSW

  • Clinical Social Worker
  • Merrillville, IN
National Provider Identifier
1558055277
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34010207A Issued in IN
Practice address
800 E 86TH Ave Ste B
Merrillville, IN 46410-6270
Phone
(219) 595-0043
Fax
(219) 237-2894
NPI assigned
Jun 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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 34010207A IN Primary

Addresses

Primary practice location

800 E 86TH Ave Ste B
Merrillville, IN 46410-6270

Mailing address

800 E 86TH Ave Ste B
Merrillville, IN 46410-6270
Phone (219) 595-0043

Other practice location 1

2467 Moss St
Portage, IN 46368-2452
Phone (219) 781-7386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240708002016 IN Practitioner - Clinical Social Worker 0042755639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nwi Clarity ClinicGroup PAC ID 5991082976, 32 clinicians

Practice addresses (Care Compare)

800 E 86TH Ave
Suite B
Merrillville, IN 46410-6270
Phone (219) 595-0043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nwi Clarity Clinic Clinical CurrentSince Jun 28, 2024 Accepting new patients

Locations

800 E 86th Ave
#B
Merrillville, IN 46410
Phone (219) 595-0043

9250 Columbia Ave
Ste 2E
Munster, IN 46321
Phone (219) 595-0043

Interoperability endpoints

  • Direct secure messaging: ccin.emily.evans@138327.advancedmd-direct.com

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1558055277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 86TH AVE STE B",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106270",
            "telephone_number": "219-595-0043",
            "fax_number": "219-237-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 86TH AVE STE B",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106270",
            "telephone_number": "219-595-0043",
            "fax_number": "219-237-2894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2467 Moss St",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463682452",
            "country_code": "US",
            "telephone_number": "219-781-7386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010207A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.