MRS. COURTNEY RENEE EVENINGRED (LLMSW) – Clinical Social Worker, NPI 1639400351

MRS. COURTNEY RENEE EVENINGRED (LLMSW) is a healthcare provider. based in Saint clair, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LLMSW. They hold a License No. 6801091817 (MI). The NPI Number for MRS. COURTNEY RENEE EVENINGRED (LLMSW) is 1639400351

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
MRS. COURTNEY RENEE EVENINGRED (LLMSW)
NPI
1639400351
Phone
(810) 329-4798
Address
1322 N RIVER RD
Enumeration Date
20 January 2010
Last Update Date
11 June 2025

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8103294798
Graduation Year
2009 (17 years ago)
PAC ID
5991959967
Group Practice PAC ID
3577460047
Professional Enrollment ID
I20130129000646
Address ID
MI480792803SA1322XRDXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness85
Years active:16State licenses:1Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

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Provider Addresses for MRS. COURTNEY RENEE EVENINGRED (LLMSW)

  • North River Road, Fort Gratiot Charter Township, Saint Clair County, Michigan, 48061, United States

    SAINT CLAIR, MI 480792803

    Phone: (810) 329-4798

    Fax: (810) 329-7303

    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: 2013-01-29

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
I20130129000646IClinical Social WorkerMITBD

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 48079)

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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: 3577460047View full group profile
NameSpecialtyState
Nurse PractitionerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical Social WorkerMI
-MI
Clinical Social WorkerMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

Can I use this page to confirm MRS. COURTNEY RENEE EVENINGRED (LLMSW)'s NPI?
Yes. MRS. COURTNEY RENEE EVENINGRED (LLMSW) is listed with NPI 1639400351 in the public NPI dataset.
Is MRS. COURTNEY RENEE EVENINGRED (LLMSW) listed as active for patients and plans?
The listing shows MRS. COURTNEY RENEE EVENINGRED (LLMSW) as active in the NPI system.
What is MRS. COURTNEY RENEE EVENINGRED (LLMSW) best known for clinically?
Directory data describes MRS. COURTNEY RENEE EVENINGRED (LLMSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is MRS. COURTNEY RENEE EVENINGRED (LLMSW) based?
MRS. COURTNEY RENEE EVENINGRED (LLMSW) is tied to Saint Clair, Michigan in the data we show; additional addresses may exist on the full record.
Why does MRS. COURTNEY RENEE EVENINGRED (LLMSW) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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