Provider Demographics
NPI:1225596414
Name:EVOLVE COUNSELING & CONSULTING LLC
Entity Type:Organization
Organization Name:EVOLVE COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINNIEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-275-7792
Mailing Address - Street 1:4352 282ND TER
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32008-2374
Mailing Address - Country:US
Mailing Address - Phone:352-275-7792
Mailing Address - Fax:
Practice Address - Street 1:1731 NW 6TH ST STE B2
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-8515
Practice Address - Country:US
Practice Address - Phone:352-275-7792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty