MEDICARE: PAULA EVANS MSW, LCSW

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	1041C0700X	Clinical Social Worker	C010953	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942672555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA EVANS MSW, LCSW

Provider Business Mailing Address
First Line	:	3920 SIENA TER
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-9752
Country	:	US
Telephone Number	:	336-417-1291
Fax Number	:

Provider Business Practice Location Address
First Line	:	3817 LAWNDALE DR STE E2
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1641
Country	:	US
Telephone Number	:	336-355-7872
Fax Number	:

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

Provider Enumeration Date	:	10/22/2015
Last Update Date	:	05/26/2026

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