| Evolution Mental Health Counseling Pllc | |
|
15 Riverside Dr Johnson City NY 13790-2742 | |
| (607) 217-4170 | |
| Not Available |
| Full Name | Evolution Mental Health Counseling Pllc |
|---|---|
| Speciality | Counselor |
| Location | 15 Riverside Dr, Johnson City, New York |
| Authorized Official Name and Position | Eli Iskandar Kassis (OWNER) |
| Authorized Official Contact | 6072174170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Mental Health Counseling Pllc 15 Riverside Dr Johnson City NY 13790-2742 Ph: (607) 217-4170 | Evolution Mental Health Counseling Pllc 15 Riverside Dr Johnson City NY 13790-2742 Ph: (607) 217-4170 |
| NPI Number | 1447962329 |
|---|---|
| Provider Enumeration Date | 12/22/2022 |
| Last Update Date | 01/18/2024 |
| Certification Date | 11/23/2022 |
| Medicare PECOS PAC ID | 1658712013 |
|---|---|
| Medicare Enrollment ID | O20240516000343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447962329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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