Provider Demographics
NPI:1972176121
Name:EVOLVE THERAPY LLC
Entity Type:Organization
Organization Name:EVOLVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:J
Authorized Official - Last Name:KARCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-791-2211
Mailing Address - Street 1:749 COMMERCE PARKWAY WEST DR STE H
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-5001
Mailing Address - Country:US
Mailing Address - Phone:317-791-2211
Mailing Address - Fax:
Practice Address - Street 1:749 COMMERCE PARKWAY WEST DR STE H
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-5001
Practice Address - Country:US
Practice Address - Phone:317-791-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty