KERRI ANNE EVANS (LCSW) – Clinical Social Worker, NPI 1073199725

KERRI ANNE EVANS (LCSW) is a healthcare provider. based in Orange park, Florida. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. SW18136 (FL). The NPI Number for KERRI ANNE EVANS (LCSW) is 1073199725

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
KERRI ANNE EVANS (LCSW)
NPI
1073199725
Phone
(904) 214-3222
Address
1532 KINGSLEY AVE STE 112
Enumeration Date
23 March 2021
Last Update Date
23 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9042143222
Graduation Year
2018 (8 years ago)
PAC ID
7618372020
Group Practice PAC ID
2860619632
Professional Enrollment ID
I20210824001283
Address ID
FL320734536OR1532XAVEX304
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,374 CLINICAL SOCIAL WORKER in FL

Provider Addresses for KERRI ANNE EVANS (LCSW)

  • 1532 KINGSLEY AVE STE 112

    ORANGE PARK, FL 320734536

    Phone: (904) 214-3222

    Fax: (904) 621-9140

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-08-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210824001283IClinical Social WorkerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32073)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860619632View full group profile
NameSpecialtyState
Nurse PractitionerFL
Mental Health CounselorFL
Clinical Social WorkerIN
Clinical Social WorkerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Clinical Social WorkerFL

Reviews

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Frequently asked questions

Does KERRI ANNE EVANS (LCSW) have a public NPI I can cite?
Public records show KERRI ANNE EVANS (LCSW) under NPI 1073199725.
Quick check: is KERRI ANNE EVANS (LCSW) active?
Public NPPES data shows KERRI ANNE EVANS (LCSW) with an active NPI status right now.
What services align with KERRI ANNE EVANS (LCSW)'s listing?
KERRI ANNE EVANS (LCSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KERRI ANNE EVANS (LCSW)?
KERRI ANNE EVANS (LCSW) is associated with Orange Park, Florida in the same public data insurers reference.
Can I export KERRI ANNE EVANS (LCSW)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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