Evelyn Stephanie Mann-Wilder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS20835 Issued in CA

Practice address

409 W. Center St
Yreka, CA 96097-2418

Phone

(530) 340-0142

Fax

(530) 842-9668

NPI assigned

Oct 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1801972195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960970405",
            "telephone_number": "530-340-0142",
            "fax_number": "530-842-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W. CENTER ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960972418",
            "telephone_number": "530-340-0142",
            "fax_number": "530-842-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN-WILDER",
        "first_name": "EVELYN",
        "middle_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-28",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS20835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arvid R Magnuson, MD
• Monica Kay Mais, F.N.P
• Michael D Maloney, MD
• Susan Malony, MS, RD
• Judith Diane Manfredi, MS, LMFT
• Seamus Mannix
• Marble Mountain Anesthesia, Inc., a Professional Nursing Corporation
• Chelsy Marriott, CD(DONA)
• David Earl Marriott, MD
• Daniel Marshall

• Clinical Social Worker in Yreka, CA
• Providers in Yreka, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.