| Evolve Counseling & Holistic Wellness Llc | |
|
513 Hume Blvd Lansing MI 48917-4247 | |
| (517) 712-9736 | |
| Not Available |
| Full Name | Evolve Counseling & Holistic Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 513 Hume Blvd, Lansing, Michigan |
| Authorized Official Name and Position | Kelly Roberson (OWNER) |
| Authorized Official Contact | 5177129736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Counseling & Holistic Wellness Llc 513 Hume Blvd Lansing MI 48917-4247 Ph: (517) 712-9736 | Evolve Counseling & Holistic Wellness Llc 513 Hume Blvd Lansing MI 48917-4247 Ph: (517) 712-9736 |
| NPI Number | 1689122830 |
|---|---|
| Provider Enumeration Date | 09/16/2016 |
| Last Update Date | 11/28/2023 |
| Certification Date | 11/28/2023 |
| Medicare PECOS PAC ID | 0648621029 |
|---|---|
| Medicare Enrollment ID | O20240110002041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689122830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Kelly S Roberson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316384480 PECOS PAC ID: 4183075567 Enrollment ID: I20240110002242 |
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