Provider Demographics
NPI:1831714815
Name:EVOLUTION MENTAL HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:EVOLUTION MENTAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-379-4431
Mailing Address - Street 1:6931 S 66TH EAST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1765
Mailing Address - Country:US
Mailing Address - Phone:918-379-4431
Mailing Address - Fax:918-328-2380
Practice Address - Street 1:6931 S 66TH EAST AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1765
Practice Address - Country:US
Practice Address - Phone:918-379-4431
Practice Address - Fax:918-328-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty