DEZIRAE MCEVOY LICSW NPI 1861940496

NPI Information

NPI: 1861940496
Provider Name: DEZIRAE MCEVOY, LICSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
4344 N 62ND ST STE 5
LINCOLN, NE
ZIP 68507
Phone: (308) 360-2444
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Dezirae Mcevoy, LICSW is a mental health counselor in Lincoln, NE with 8 years of experience. Dezirae Mcevoy, LICSW NPI is 1861940496. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4344 N 62ND ST STE 5
LINCOLN, NE
ZIP 68507-251
Phone: (308) 360-2444

The NPI 1861940496 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 9/12/2016 and was last updated on 1/16/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	2053	NEBRASKA	Yes
2	1041C0700X	Social Worker	Clinical	1769	NEBRASKA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11007	OTHER	NEBRASKA	NE PLMHP LICENSURE
2	1769	OTHER	NEBRASKA	NEBRASKA LICENSED MASTER SOCIAL WORKER
3	2053	OTHER	NEBRASKA	NEBRASKA LICENSED INDEPENDENT MENTAL HEALTH PRACTITIONER (LIMHP)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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