Blythe Evans, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006814 Issued in CT

Practice address

12 Red Barn LN
Brookfield, CT 06804-3700

Phone

(203) 775-4294

Fax

(203) 346-6119

NPI assigned

Oct 1, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1902233299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 RED BARN LN",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068043700",
            "telephone_number": "203-775-4294",
            "fax_number": "203-346-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 RED BARN LN",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068043700",
            "telephone_number": "203-775-4294",
            "fax_number": "203-346-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "BLYTHE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie Jeanne Ehnot, AGNP-C
• Brittney Amber Ek, PA
• Grace Elizabeth Englund, OTR/L
• Laura Christine Erhardt, MS,LMFT,ND
• Paul J Esposito, DDS
• Deann Ewart, PH.D.
• Kara Falcone
• Matthew Farrell, M.D.
• Jenny Tekla Federman, DMD
• Shane Fedigan, BCBA, LBA-CT

• Clinical Social Worker in Brookfield, CT
• Providers in Brookfield, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.