Evelyn Nicole Roberts, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

3059 Edgewood CT
Columbus, GA 31907-2593

Phone

(205) 240-0498

NPI assigned

Feb 2, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Evelyn Nicole Mitchell Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Horizons Area MH Mr Sa Program

  • Clinic/Center
  • Columbus, GA
  • NPI 1154315422
  Medicare reassignment NPD
• Valley Healthcare System Inc

  • Federally Qualified Health Center (FQHC)
  • Fortson, GA
  • NPI 1952599623
  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  GA

  Medicare reassignment NPD
• Four Thirteen Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Columbus, GA
  • NPI 1235887589
  NPD Authorized official
• Valley Healthcare System

  • Federally Qualified Health Center (FQHC)
  • Columbus, GA
  • NPI 1851924377
  NPD
• New Horizons CSB Reach Center

  • Counselor
  • Columbus, GA
  • NPI 1609929157
  NPD (past)

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1902264294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3059 EDGEWOOD CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319072593",
            "telephone_number": "205-240-0498",
            "fax_number": "706-327-5294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 EDGEWOOD CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319072593",
            "telephone_number": "205-240-0498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Fort Benning Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319032834",
            "country_code": "US",
            "telephone_number": "706-322-9599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "EVELYN",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "MITCHELL",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Venita Teresa Roberson, FNP
• Robert a Vazquez DDS, PC
• Robert G. Palerino, MD
• Dewayne Robert
• Jennifer Catherine Roberts-Woodbury, D.O.
• Frederick T Roberts, MD
• James Roberts V, MLT
• Kathleen Roberts, M.D.
• Kristin Roberts, LPC
• Marilyn Nichole Moulton Roberts, PA-C

• Clinical Social Worker in Columbus, GA
• Providers in Columbus, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.