Individual provider Active NPI

Evelyn Dejesus, LCSW

  • Clinical Social Worker
  • Sebring, FL
National Provider Identifier
1619495231
Registry record updated May 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14744 Issued in FL
Practice address
6412 US Highway 27 S
Sebring, FL 33876-5711
Phone
(863) 991-3232
NPI assigned
Sep 4, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2023

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 SW14744 FL Primary

Addresses

Primary practice location

6412 US Highway 27 S
Sebring, FL 33876-5711

Mailing address

6412 US Highway 27 S
Sebring, FL 33876-5711
Phone (863) 991-3232

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@myinnerjourney.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20191004000412 FL Practitioner - Clinical Social Worker 0840550612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14744FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rhodium Care Group Florida PA Clinical CurrentSince Apr 10, 2024 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Aug 15, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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": "1504483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684540800000",
    "number": "1619495231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 US HIGHWAY 27 S",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338765711",
            "telephone_number": "863-991-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 US HIGHWAY 27 S",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338765711",
            "telephone_number": "863-991-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "EVELYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-04",
        "last_updated": "2023-05-20",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@myinnerjourney.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6412 US Highway 27 S",
            "city": "Sebring",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338765711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.