| Evolve Counseling Center Llc | |
|
2999 Ne 191st St Suite 701 Aventura FL 33180-3123 | |
| (786) 505-1145 | |
| (866) 838-1482 |
| Full Name | Evolve Counseling Center Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2999 Ne 191st St, Aventura, Florida |
| Authorized Official Name and Position | Tanya Johnson (OWNER) |
| Authorized Official Contact | 8083430626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Counseling Center Llc 2999 Ne 191st St Suite 701 Aventura FL 33180-3123 Ph: (786) 505-1145 | Evolve Counseling Center Llc 2999 Ne 191st St Suite 701 Aventura FL 33180-3123 Ph: (786) 505-1145 |
| NPI Number | 1104272624 |
|---|---|
| Provider Enumeration Date | 05/13/2016 |
| Last Update Date | 05/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104272624 | NPI | - | NPPES |
| 015682200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH11793 (Florida) | Primary |
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