| Evolve Virtual Counseling LLC | |
|
1 Easy St Jasper IN 47546-8145 | |
| (812) 639-9943 | |
| Not Available |
| Full Name | Evolve Virtual Counseling LLC |
|---|---|
| Speciality | Social Worker |
| Location | 1 Easy St, Jasper, Indiana |
| Authorized Official Name and Position | Christine Vaal (OWNER) |
| Authorized Official Contact | 8126399943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Virtual Counseling LLC 1 Easy St Jasper IN 47546-8145 Ph: (812) 639-9943 | Evolve Virtual Counseling LLC 1 Easy St Jasper IN 47546-8145 Ph: (812) 639-9943 |
| NPI Number | 1427764125 |
|---|---|
| Provider Enumeration Date | 01/25/2023 |
| Last Update Date | 01/25/2023 |
| Certification Date | 01/25/2023 |
| Medicare PECOS PAC ID | 2769857945 |
|---|---|
| Medicare Enrollment ID | O20230403000262 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427764125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Christine Vaal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558787853 PECOS PAC ID: 9335370584 Enrollment ID: I20140401001201 |
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