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Evan G Tacey

Social Worker in Niles, MI. Individual provider (NPI-1).

NPI number1700524253
StatusActive
Last updated in NPPESMay 24, 2022

Details

NPI
1700524253
Entity type
Individual (NPI-1)
Name
Evan G Tacey
Sex
Male
Sole proprietor
Yes
Enumeration date
May 24, 2022
Certification date
May 24, 2022
Last updated
May 24, 2022

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - FAMILY PRACTICE
Can order and refer
Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
104100000X Social Worker––Yes

Practice location

20 N 2nd St Ste 103
Niles, MI 49120-2259

Phone 269-262-1815

Mailing address

20 N 2nd St Ste 103
Niles, MI 49120-2259

Phone 269-262-1815

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Social Worker providers in Niles, MI

All 6 Social Worker providers in Niles · All 619 providers in Niles

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