Provider Demographics
NPI:1669296943
Name:EVOLUTION COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:EVOLUTION COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:DANIELS
Authorized Official - Last Name:HAPPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-603-3903
Mailing Address - Street 1:3404 ACORN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1095
Mailing Address - Country:US
Mailing Address - Phone:757-603-3903
Mailing Address - Fax:
Practice Address - Street 1:3404 ACORN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-1095
Practice Address - Country:US
Practice Address - Phone:757-603-3903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health