| Evolving Lives Llc | |
|
1990 Louisville Rd Ste 107 Bowling Green KY 42101-1202 | |
| (270) 495-1222 | |
| (859) 209-6504 |
| Full Name | Evolving Lives Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1990 Louisville Rd Ste 107, Bowling Green, Kentucky |
| Authorized Official Name and Position | Adria Whitlow (OWNER) |
| Authorized Official Contact | 2704951222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolving Lives Llc 1990 Louisville Rd Ste 107 Bowling Green KY 42101-1202 Ph: (270) 495-1222 | Evolving Lives Llc 1990 Louisville Rd Ste 107 Bowling Green KY 42101-1202 Ph: (270) 495-1222 |
| NPI Number | 1477144046 |
|---|---|
| Provider Enumeration Date | 01/27/2021 |
| Last Update Date | 08/11/2023 |
| Certification Date | 08/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477144046 | NPI | - | NPPES |
| 7100720500 | Medicaid | KY | |
| 7100682470 | Medicaid | KY | |
| 7100811550 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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