NPIMap

Organization Active NPI

Evolution to Wellness

  • Community/Behavioral Health Agency
  • Cleveland, OH
National Provider Identifier
1104518919
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EVOLUTION TO WELLNESS
Practice address
3100 E 45TH St Ste 406
Cleveland, OH 44127-1095
Phone
(216) 415-9325
NPI assigned
May 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Latheresa WilliamsNPI 1215578083
Title
President
Phone
(216) 415-9325

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
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3100 E 45TH St Ste 406
Cleveland, OH 44127-1095

Mailing address

3992 E 144TH St
Cleveland, OH 44128-1870
Phone (216) 415-9325

National Provider Directory

National Provider Directory

Locations

3100 E 45th St
Ste 406
Cleveland, OH 44127
Phone (216) 415-9325

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1104518919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3992 E 144TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441281870",
            "telephone_number": "216-415-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E 45TH ST STE 406",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271095",
            "telephone_number": "216-415-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION TO WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LATHERESA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-415-9325"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.