| Evolve Mental Wellness | |
|
1411 Wesley Dr Salisbury MD 21801-7149 | |
| (410) 642-4011 | |
| Not Available |
| Full Name | Evolve Mental Wellness |
|---|---|
| Speciality | Counselor |
| Location | 1411 Wesley Dr, Salisbury, Maryland |
| Authorized Official Name and Position | Valerie Anderson (OWNER) |
| Authorized Official Contact | 4106424011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Mental Wellness 1411 Wesley Dr Salisbury MD 21801-7149 Ph: (410) 642-4011 | Evolve Mental Wellness 1411 Wesley Dr Salisbury MD 21801-7149 Ph: (410) 642-4011 |
| NPI Number | 1912597857 |
|---|---|
| Provider Enumeration Date | 01/25/2021 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Medicare PECOS PAC ID | 6608266846 |
|---|---|
| Medicare Enrollment ID | O20211202001909 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912597857 | NPI | - | NPPES |
| Provider Name | Carla D Eichenmiller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841360310 PECOS PAC ID: 1153377692 Enrollment ID: I20050328000588 |
| Provider Name | Manjula P Borge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972685840 PECOS PAC ID: 8921007279 Enrollment ID: I20080822000160 |
| Provider Name | Sandra A Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245586122 PECOS PAC ID: 1557511060 Enrollment ID: I20121018000312 |
| Provider Name | Kristen Lynn Gordy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811332307 PECOS PAC ID: 5799912234 Enrollment ID: I20131209000943 |
| Provider Name | Wendy L Holder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124115811 PECOS PAC ID: 5496724254 Enrollment ID: I20131213000216 |
| Provider Name | Valerie W Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639467335 PECOS PAC ID: 5294951307 Enrollment ID: I20140725002071 |
| Provider Name | Jason H Sammons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396023248 PECOS PAC ID: 0840418778 Enrollment ID: I20140905001521 |
| Provider Name | Amy Nicholson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306257316 PECOS PAC ID: 2567680457 Enrollment ID: I20140908000928 |
| Provider Name | Jennifer L Youdom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427482942 PECOS PAC ID: 9830482983 Enrollment ID: I20160727000220 |
| Provider Name | Rani M George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225562937 PECOS PAC ID: 7618245051 Enrollment ID: I20170608000115 |
| Provider Name | Kristin L Hearne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457825671 PECOS PAC ID: 5698014785 Enrollment ID: I20190307001661 |
| Provider Name | Amy E Searcey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174975312 PECOS PAC ID: 6608100367 Enrollment ID: I20190628002572 |
| Provider Name | Mary B Brinsfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164067476 PECOS PAC ID: 1557796190 Enrollment ID: I20200108002962 |
| Provider Name | Amanda Marie Frey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851890479 PECOS PAC ID: 2062817158 Enrollment ID: I20210827001641 |
| Provider Name | E. Jane Vickers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336804384 PECOS PAC ID: 1658763826 Enrollment ID: I20220120000297 |
| Provider Name | Courtney Aley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356094585 PECOS PAC ID: 0648665687 Enrollment ID: I20220309003073 |
| Provider Name | Kaitlyn Nicole Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881171510 PECOS PAC ID: 3274929807 Enrollment ID: I20220408000263 |
| Provider Name | Jannia Marie Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720544406 PECOS PAC ID: 5890178677 Enrollment ID: I20220810003924 |
| Provider Name | Celeste J Welch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821664467 PECOS PAC ID: 5496122178 Enrollment ID: I20221109002178 |
| Provider Name | Karen Ashley Walls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962033167 PECOS PAC ID: 9234501628 Enrollment ID: I20230213001248 |
| Provider Name | Amanda Eberly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083151823 PECOS PAC ID: 3173977261 Enrollment ID: I20230922002025 |
| Provider Name | Ashley Toulson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194591396 PECOS PAC ID: 6507216660 Enrollment ID: I20240102002331 |
| Provider Name | Pamela Ann Patey Weeg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194995456 PECOS PAC ID: 8325438567 Enrollment ID: I20240430002570 |
| Provider Name | Elizabeth Andrea Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316370166 PECOS PAC ID: 0547600645 Enrollment ID: I20240506001692 |
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