Individual provider Active NPI

Linda Mae Evans, LCSW

  • Clinical Social Worker
  • Pinehurst, NC
National Provider Identifier
1700963196
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C000270 Issued in NC
Practice address
289 Olmsted Blvd
Suite 1
Pinehurst, NC 28374-8729
Phone
(910) 295-6007
Fax
(910) 215-0179
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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 C000270 NC Primary

Addresses

Primary practice location

289 Olmsted Blvd
Suite 1
Pinehurst, NC 28374-8729

Mailing address

PO Box 1630
Pinehurst, NC 28370-1630
Phone (910) 295-6007

Other identifiers 1

IdentifierTypeStateIssuer
6106142MedicaidNC

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
C000270NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1700963196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1630",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283701630",
            "telephone_number": "910-295-6007",
            "fax_number": "910-215-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 OLMSTED BLVD",
            "address_2": "SUITE 1",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748729",
            "telephone_number": "910-295-6007",
            "fax_number": "910-215-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LINDA",
        "middle_name": "MAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106142",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.