| Evolving Mind Solutions, Llc | |
|
4200 S Hulen St Ste 678 Fort Worth TX 76109-7902 | |
| (817) 203-4779 | |
| Not Available |
| Full Name | Evolving Mind Solutions, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4200 S Hulen St Ste 678, Fort Worth, Texas |
| Authorized Official Name and Position | Sarah Ryan Wellborn (PRESIDENT) |
| Authorized Official Contact | 8172034779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolving Mind Solutions, Llc 4200 S Hulen St Ste 678 Fort Worth TX 76109-7902 Ph: (817) 203-4779 | Evolving Mind Solutions, Llc 4200 S Hulen St Ste 678 Fort Worth TX 76109-7902 Ph: (817) 203-4779 |
| NPI Number | 1326681354 |
|---|---|
| Provider Enumeration Date | 10/22/2019 |
| Last Update Date | 10/09/2024 |
| Certification Date | 10/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326681354 | NPI | - | NPPES |
| 1225577471 | Other | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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