Provider Demographics
NPI:1639667652
Name:EVOLVE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:EVOLVE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-440-5475
Mailing Address - Street 1:2601 S LEMAY AVE
Mailing Address - Street 2:STE. 7 #152
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2298
Mailing Address - Country:US
Mailing Address - Phone:970-232-9339
Mailing Address - Fax:970-232-9367
Practice Address - Street 1:1136 E. STUART
Practice Address - Street 2:BLDG. 4 STE. 101
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525
Practice Address - Country:US
Practice Address - Phone:970-232-9339
Practice Address - Fax:970-232-9367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0006480261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health