Active NPI
Evelyn Medina, MSW
- Clinical Social Worker
- Quebradillas, PR
National Provider Identifier
1861797672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8283
- Practice address
- Calle Felipe Cruz
42587
Quebradillas, PR 00678-9307 - Phone
- (787) 644-6594
- NPI assigned
- Jan 26, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8283 | PR | Primary |
Addresses
Primary practice location
Calle Felipe Cruz
42587
Quebradillas, PR 00678-9307
Mailing address
Calle Felipe Cruz
42587
Quebradillas, PR 00678-9307
Phone (787) 644-6594
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8283 | PR | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296000000000",
"number": "1861797672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CALLE FELIPE CRUZ",
"address_2": "42587",
"city": "QUEBRADILLAS",
"state": "PR",
"postal_code": "006789307",
"telephone_number": "787-644-6594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE FELIPE CRUZ",
"address_2": "42587",
"city": "QUEBRADILLAS",
"state": "PR",
"postal_code": "006789307",
"telephone_number": "787-644-6594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "EVELYN",
"name_prefix": "Miss",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-26",
"last_updated": "2011-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PR",
"license": "8283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quebradillas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.