Individual provider Active NPI

Glenda Sue Eversole, LCSW

  • Social Worker
  • Cabot, AR
National Provider Identifier
1750660197
Registry record updated Feb 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
217 W Main St
Cabot, AR 72023-2944
Phone
(501) 743-9470
Fax
(501) 843-1217
NPI assigned
Aug 16, 2011
Last updated
Feb 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X AR Primary

Addresses

Primary practice location

217 W Main St
Cabot, AR 72023-2944

Mailing address

41 Glendale Dr
Cabot, AR 72023-2467
Phone (501) 743-9470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20180425002215 AR Practitioner - Clinical Social Worker 6406110519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Growing Hope Counseling, PLLCGroup PAC ID 1052675162, 2 clinicians

Practice addresses (Care Compare)

362 E Main St
Suite B
Cabot, AR 72023-3035
Phone (501) 286-6618

500 E Mountain Springs Rd
Cabot, AR 72023-2435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423872000000",
    "number": "1750660197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 GLENDALE DR",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720232467",
            "telephone_number": "501-743-9470",
            "fax_number": "501-843-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W MAIN ST",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720232944",
            "telephone_number": "501-743-9470",
            "fax_number": "501-843-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSOLE",
        "first_name": "GLENDA",
        "middle_name": "SUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2015-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabot, AR

Sources for this page

Verify at the official NPI Registry.