| Chakiara Payne, | |
| 
					6309 Mack Ave, Detroit, MI 48207-2302  | |
| (313) 331-3435 | |
| Not Available | 
| Full Name | Chakiara Payne | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Professional | 
| Location | 6309 Mack Ave, Detroit, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1184348989 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6401223725 (Michigan) | Primary | 
| Entity Name | Evolutionary Intervention Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1679846505 PECOS PAC ID: 0244646610 Enrollment ID: O20210309002954  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Chakiara Payne, 7052 Meadow Ave, Warren, MI 48091-3018 Ph: (810) 342-9061  | Chakiara Payne, 6309 Mack Ave, Detroit, MI 48207-2302 Ph: (313) 331-3435  | 
Anthony Jerome Allen, AAS.,  CAC II Counselor Medicare: Not Enrolled in Medicare Practice Location: 12010 Linwood St, Detroit, MI 48206 Phone: 313-867-1090 Fax: 313-867-0706  | |
Mr. Brian R Cogliati,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 1852 W Grand Blvd, 1852 W. Grand Blvd, Detroit, MI 48208 Phone: 313-894-8444 Fax: 313-894-5542  | |
Mr. Gregory Charles Guice, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1151 Taylor Ave., Detroit, MI 48202 Phone: 313-874-8715  | |
Ms. Carol Potter, MA, BCBA, LBA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2200 Hunt St, Detroit, MI 48207 Phone: 248-537-2516  | |
Mrs. Lisa Polk-woolfolk, MS, LLPC, CAC-M Counselor Medicare: Not Enrolled in Medicare Practice Location: 3731 Rivard St, Detroit, MI 48207 Phone: 313-258-9713  | |
Alicia Monique Lurry, LPC Counselor Medicare: Medicare Enrolled Practice Location: 8171 Parkland, Detroit, MI 48239 Phone: 313-282-7567  | |
Mr. Darren Kilgore,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 269 Walker St, 538, Detroit, MI 48207 Phone: 313-610-0134  |