Individual provider Active NPI

Kataryna Marie Evanowicz, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1942998125
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW023395 Issued in PA
Practice address
4601 Market St
Philadelphia, PA 19139-4636
Phone
(215) 590-7555
NPI assigned
Apr 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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 CW023395 PA Primary

Addresses

Primary practice location

4601 Market St
Philadelphia, PA 19139-4636

Mailing address

4601 Market St
Philadelphia, PA 19139-4636
Phone (215) 590-7555

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

LicenseStateTypeSpecialty
CW023395PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1942998125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394636",
            "telephone_number": "215-590-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394636",
            "telephone_number": "215-590-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANOWICZ",
        "first_name": "KATARYNA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW023395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.