Evolution Wellness Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EVOLUTION WELLNESS CENTER

Practice address

2701 S Vassar CT
Wichita, KS 67210-1155

Phone

(316) 512-1658

NPI assigned

Oct 9, 2024

Last updated

Oct 9, 2024By 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

Olivia TicklesNPI 1578390647

Title

Owner

Phone

(316) 519-6063

Specialties & licenses 2

Addresses

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.

• Olivia S Tickles

  • Mental Health Counselor
  • Wichita, KS
  • NPI 1578390647
  NPD Authorized official

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1073332771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N ROOSEVELT ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672202815",
            "telephone_number": "316-512-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 S VASSAR CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672101155",
            "telephone_number": "316-512-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "TICKLES",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-519-6063"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Wichita, KS
• Providers in Wichita, KS by specialty
• Mental Health Counselor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.