Active NPI
Evelyn Lorisa Taylor, LCSW
- Clinical Social Worker
- Trumann, AR
National Provider Identifier
1679623763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7144-C
- Practice address
- 1704 Hwy 69 West
Trumann, AR 72472-2029 - Phone
- (870) 483-4003
- Fax
- (870) 483-4009
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | LSW0000004502 | TN | |
| Clinical Social Worker | 1041C0700X | 7144-C | AR | Primary |
Addresses
Primary practice location
1704 Hwy 69 West
Trumann, AR 72472-2029
Mailing address
1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone (870) 933-6886
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5CC77 | Other | AR | BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7144-C | AR | MD | Clinical Social Worker |
| LSW0000004502 | TN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J. Sidney Alexander, M.D., P.C. | Past | Accepting new patients |
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.
-
- Psychiatry Physician
- Knoxville, TN
- NPI 1538204003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526428800000",
"number": "1679623763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 PLEASANT GROVE RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724017870",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 HWY 69 WEST",
"city": "TRUMANN",
"state": "AR",
"postal_code": "724722029",
"telephone_number": "870-483-4003",
"fax_number": "870-483-4009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "EVELYN",
"middle_name": "LORISA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2018-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "LSW0000004502",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "7144-C",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5CC77",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Trumann, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.