Provider Demographics
NPI:1467817049
Name:THOUGHT EVOLUTION LLC.
Entity Type:Organization
Organization Name:THOUGHT EVOLUTION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:667-303-3314
Mailing Address - Street 1:1111 PARK AVE STE L103
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5651
Mailing Address - Country:US
Mailing Address - Phone:443-945-8581
Mailing Address - Fax:667-303-3319
Practice Address - Street 1:1111 PARK AVE APT 410
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5608
Practice Address - Country:US
Practice Address - Phone:667-303-3314
Practice Address - Fax:667-303-3319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA1636251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health