Individual provider Active NPI

Earlene M Evans, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1932286598
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
02442C Issued in NV
Practice address
1885 Village Center Cir
Las Vegas, NV 89134-6369
Phone
(702) 656-6893
Fax
(702) 248-2008
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

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
Clinical Social Worker 1041C0700X 02442C NV Primary

Addresses

Primary practice location

1885 Village Center Cir
Las Vegas, NV 89134-6369

Mailing address

PO Box 35409
Las Vegas, NV 89133-5409
Phone (702) 656-6893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20040226001033 NV Practitioner - Clinical Social Worker 3971499708 Practice locations: Las Vegas, NV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Las Vegas, NV 89145
Phone (702) 656-6893

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02442CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ventana Health Associates Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932286598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35409",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335409",
            "telephone_number": "702-656-6893",
            "fax_number": "702-248-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 VILLAGE CENTER CIR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346369",
            "telephone_number": "702-656-6893",
            "fax_number": "702-248-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "EARLENE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "02442C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.