Evolution Counseling Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EVOLUTION COUNSELING SERVICES

Practice address

2716 N Broadway Ste 205
Los Angeles, CA 90031-2635

Phone

(323) 285-0290

NPI assigned

Dec 12, 2019

Last updated

Dec 12, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yadira Haydee Enriquez, LCSWNPI 1043670649

Title

Owner

Phone

(323) 285-0290

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yadira Haydee Enriquez, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1043670649
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1003454760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 N BROADWAY STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312635",
            "telephone_number": "323-285-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 N BROADWAY STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312635",
            "telephone_number": "323-285-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "ENRIQUEZ",
        "authorized_official_first_name": "YADIRA",
        "authorized_official_middle_name": "HAYDEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-285-0290",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2716 N Broadway Ste 205",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900312635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.