Evolving Lives Llc | |
1990 Louisville Rd Ste 107 Bowling Green KY 42101-1202 | |
(270) 495-1222 | |
(859) 209-6504 |
Full Name | Evolving Lives Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 1990 Louisville Rd Ste 107, Bowling Green, Kentucky |
Authorized Official Name and Position | Adria Whitlow (OWNER) |
Authorized Official Contact | 2704951222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Evolving Lives Llc 1990 Louisville Rd Ste 107 Bowling Green KY 42101-1202 Ph: (270) 495-1222 | Evolving Lives Llc 1990 Louisville Rd Ste 107 Bowling Green KY 42101-1202 Ph: (270) 495-1222 |
NPI Number | 1477144046 |
---|---|
Provider Enumeration Date | 01/27/2021 |
Last Update Date | 08/11/2023 |
Certification Date | 08/11/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477144046 | NPI | - | NPPES |
7100720500 | Medicaid | KY | |
7100682470 | Medicaid | KY | |
7100811550 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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