Provider Demographics
NPI:1013575141
Name:EVOLVING LIFE COUNSELING AND PSYCHOTHERAPY PLLC
Entity Type:Organization
Organization Name:EVOLVING LIFE COUNSELING AND PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:ZANETA
Authorized Official - Last Name:GATLING
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:910-212-4441
Mailing Address - Street 1:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702-0315
Mailing Address - Country:US
Mailing Address - Phone:910-212-4441
Mailing Address - Fax:844-965-9504
Practice Address - Street 1:3622 MORGANTON RD STE B
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4967
Practice Address - Country:US
Practice Address - Phone:910-212-4441
Practice Address - Fax:844-965-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty