Individual provider Active NPI

Evelyn Carbonell, LCSW

  • Professional Counselor
  • Punta Gorda, FL
National Provider Identifier
1811088743
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
SW5150 Issued in FL
Practice address
1700 Education Ave
Punta Gorda, FL 33950-6222
Phone
(941) 639-8300
Fax
(941) 639-6831
NPI assigned
Sep 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X SW5150 FL Primary

Addresses

Primary practice location

1700 Education Ave
Punta Gorda, FL 33950-6222

Mailing address

5007 Palermo Dr
Punta Gorda, FL 33950-8033
Phone (941) 815-0266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160629002189 FL Practitioner - Clinical Social Worker 5991097586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10201 Arcos Ave
Suite 201
Estero, FL 33928-9461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Norma Henriquez PL Past Accepting new patients

Organizations & group practices 2

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811088743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5007 PALERMO DR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339508033",
            "telephone_number": "941-815-0266",
            "fax_number": "941-639-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 EDUCATION AVE",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339506222",
            "telephone_number": "941-639-8300",
            "fax_number": "941-639-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONELL",
        "first_name": "EVELYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "SW5150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.