Provider Demographics
NPI:1518357797
Name:EVOLVE COUNSELING & TRAINING LLC
Entity Type:Organization
Organization Name:EVOLVE COUNSELING & TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:603-716-1282
Mailing Address - Street 1:55 S COMMERCIAL ST
Mailing Address - Street 2:BOX 3A
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2606
Mailing Address - Country:US
Mailing Address - Phone:603-716-1282
Mailing Address - Fax:603-296-0839
Practice Address - Street 1:55 S COMMERCIAL ST
Practice Address - Street 2:BOX 3A
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2606
Practice Address - Country:US
Practice Address - Phone:603-716-1282
Practice Address - Fax:603-296-0839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH946251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health