MEDICARE: ERICA L. EVANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW143018	PA

General Provider Information

NPI Number	:	1770432510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA L. EVANS

Provider Business Mailing Address
First Line	:	5221 GERMANTOWN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-2301
Country	:	US
Telephone Number	:	215-802-3533
Fax Number	:

Provider Business Practice Location Address
First Line	:	5221 GERMANTOWN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-2301
Country	:	US
Telephone Number	:	215-802-3533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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