Provider Demographics
NPI:1497575377
Name:EVO COUNSELING & ECOTHERAPY, LLC
Entity type:Organization
Organization Name:EVO COUNSELING & ECOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMBURRO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:724-277-6370
Mailing Address - Street 1:331 HILL CHURCHES RD
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-5282
Mailing Address - Country:US
Mailing Address - Phone:724-277-6370
Mailing Address - Fax:
Practice Address - Street 1:331 HILL CHURCHES RD
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-5282
Practice Address - Country:US
Practice Address - Phone:724-277-6370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty