| Evolve Counseling & Neurofeedback Center Inc | |
|
225 Ne C St Grants Pass OR 97526-2175 | |
| (541) 500-8655 | |
| (800) 433-1396 |
| Full Name | Evolve Counseling & Neurofeedback Center Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 225 Ne C St, Grants Pass, Oregon |
| Authorized Official Name and Position | Darnel Scott (OWNER) |
| Authorized Official Contact | 5412185171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Counseling & Neurofeedback Center Inc Po Box 1787 Medford OR 97501-0261 Ph: (541) 500-8655 | Evolve Counseling & Neurofeedback Center Inc 225 Ne C St Grants Pass OR 97526-2175 Ph: (541) 500-8655 |
| NPI Number | 1295506327 |
|---|---|
| Provider Enumeration Date | 01/09/2024 |
| Last Update Date | 05/14/2024 |
| Certification Date | 05/14/2024 |
| Medicare PECOS PAC ID | 8527500719 |
|---|---|
| Medicare Enrollment ID | O20240603003321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295506327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Darnel G Scott |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1831376656 PECOS PAC ID: 0345782538 Enrollment ID: I20240603003362 |
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