Evolve Counseling Center Llc | |
2999 Ne 191st St Suite 701 Aventura FL 33180-3123 | |
(786) 505-1145 | |
(866) 838-1482 |
Full Name | Evolve Counseling Center Llc |
---|---|
Speciality | Counselor - Mental Health |
Location | 2999 Ne 191st St, Aventura, Florida |
Authorized Official Name and Position | Tanya Johnson (OWNER) |
Authorized Official Contact | 8083430626 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Evolve Counseling Center Llc 2999 Ne 191st St Suite 701 Aventura FL 33180-3123 Ph: (786) 505-1145 | Evolve Counseling Center Llc 2999 Ne 191st St Suite 701 Aventura FL 33180-3123 Ph: (786) 505-1145 |
NPI Number | 1104272624 |
---|---|
Provider Enumeration Date | 05/13/2016 |
Last Update Date | 05/13/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104272624 | NPI | - | NPPES |
015682200 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | MH11793 (Florida) | Primary |
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