Provider Demographics
NPI:1497201560
Name:EVOLUTION WELLNESS, LLC
Entity Type:Organization
Organization Name:EVOLUTION WELLNESS, LLC
Other - Org Name:SARAH COX, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MIRANDA
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-488-8446
Mailing Address - Street 1:149 GOLF CLUB DR
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4381
Mailing Address - Country:US
Mailing Address - Phone:704-488-8446
Mailing Address - Fax:
Practice Address - Street 1:149 GOLF CLUB DR
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4381
Practice Address - Country:US
Practice Address - Phone:704-488-8446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLSW11903251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty