NPIMap

Organization Active NPI

KRC Counseling Inc.

Doing business as Evolution Wellness

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1023557154
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C010221 Issued in NC
Legal business name
KRC COUNSELING INC.
Doing business as
Evolution Wellness
Practice address
2301 Delaney Ave
Wilmington, NC 28403-6012
Phone
(910) 202-4326
Fax
(910) 679-6347
NPI assigned
Feb 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Authorized official

Name
Kayla Reilly, MSW, LCSWNPI 1770990665
Title
Owner
Phone
(910) 409-8958

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C010221 NC Primary

Addresses

Primary practice location

2301 Delaney Ave
Wilmington, NC 28403-6012

Mailing address

2301 Delaney Ave
Wilmington, NC 28403-6012
Phone (910) 202-4326

Other practice location 1

202 1/2 Princess St
Wilmington, NC 28401-3951
Phone (910) 202-4326

Other names 1

  • Evolution Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

502 Market St
Wilmington, NC 28401

202 Princess St
Wilmington, NC 28401

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1023557154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 DELANEY AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036012",
            "telephone_number": "910-202-4326",
            "fax_number": "910-679-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 DELANEY AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036012",
            "telephone_number": "910-202-4326",
            "fax_number": "910-679-6347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 1/2 Princess St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284013951",
            "country_code": "US",
            "telephone_number": "910-202-4326",
            "fax_number": "910-679-6347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KRC COUNSELING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-22",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-409-8958",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolution Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.