Individual provider Active NPI

Evette Clemons, CSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1649076837
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
260073 Issued in KY
Practice address
2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009
Phone
(859) 254-1035
NPI assigned
Feb 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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 260073 KY Primary

Addresses

Primary practice location

2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009

Mailing address

9821 Collier LN
Louisville, KY 40291-3185

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

State licenses

LicenseStateTypeSpecialty
260073KYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1649076837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9821 COLLIER LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402913185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 THUNDERSTICK DR STE 1104",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405059009",
            "telephone_number": "859-254-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "EVETTE",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "260073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.