Individual provider Active NPI

Logan Dean Evans, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1881264521
Registry record updated Oct 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
099464 Issued in NY
Practice address
921 E New York Ave
Brooklyn, NY 11203-1393
Phone
(718) 778-0485
NPI assigned
Jun 25, 2021
Last updated
Oct 19, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 108469 NY
Clinical Social Worker 1041C0700X 099464 NY Primary

Addresses

Primary practice location

921 E New York Ave
Brooklyn, NY 11203-1393

Mailing address

921 E New York Ave
Brooklyn, NY 11203-1393
Phone (718) 778-0485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250328002768 NY Practitioner - Clinical Social Worker 5496278558

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229-1209

1664 E 14TH St
Suite 501
Brooklyn, NY 11229-1209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108469NYMDSocial Worker
099464NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. Social Worker CurrentSince Mar 3, 2025 Accepting new patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Mar 3, 2025 Accepting new patients

Locations

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

921 E New York Ave
Brooklyn, NY 11203
Phone (718) 778-0485

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": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1881264521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E NEW YORK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031393",
            "telephone_number": "718-778-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 E NEW YORK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031393",
            "telephone_number": "718-778-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LOGAN",
        "middle_name": "DEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2021-06-25",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "108469",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.