| Evolve Therapy And Wellness | |
|
401 S Main St Unit 2 Somerset KY 42501-2016 | |
| (606) 451-8805 | |
| Not Available |
| Full Name | Evolve Therapy And Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 401 S Main St Unit 2, Somerset, Kentucky |
| Authorized Official Name and Position | Deanna Phillips (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6068751774 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Therapy And Wellness 401 S Main St Unit 2 Somerset KY 42501-2016 Ph: (606) 451-8805 | Evolve Therapy And Wellness 401 S Main St Unit 2 Somerset KY 42501-2016 Ph: (606) 451-8805 |
| NPI Number | 1417739418 |
|---|---|
| Provider Enumeration Date | 10/16/2023 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/04/2024 |
| Medicare PECOS PAC ID | 5698210722 |
|---|---|
| Medicare Enrollment ID | O20240713000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417739418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelli N Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710380035 PECOS PAC ID: 7810268711 Enrollment ID: I20170811000708 |
| Provider Name | Deanna Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215634902 PECOS PAC ID: 8224402656 Enrollment ID: I20230324002145 |
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