| (w)evolve Therapy Services | |
|
1715 S Broadway Minot ND 58701-6304 | |
| (701) 355-6800 | |
| Not Available |
| Full Name | (w)evolve Therapy Services |
|---|---|
| Speciality | Social Worker |
| Location | 1715 S Broadway, Minot, North Dakota |
| Authorized Official Name and Position | Lea Anna Hughes (OWNER) |
| Authorized Official Contact | 2083058540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| (w)evolve Therapy Services 1715 S Broadway Minot ND 58701-6304 Ph: (701) 355-6800 | (w)evolve Therapy Services 1715 S Broadway Minot ND 58701-6304 Ph: (701) 355-6800 |
| NPI Number | 1386211282 |
|---|---|
| Provider Enumeration Date | 06/08/2021 |
| Last Update Date | 07/05/2024 |
| Certification Date | 07/05/2024 |
| Medicare PECOS PAC ID | 8921540576 |
|---|---|
| Medicare Enrollment ID | O20240611000850 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386211282 | NPI | - | NPPES |
| 1492384 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shannon M Stremick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396257986 PECOS PAC ID: 4385904846 Enrollment ID: I20180201002852 |
| Provider Name | Lea Anna Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417477969 PECOS PAC ID: 0547675274 Enrollment ID: I20210210002448 |
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