Evolving Yourself Therapy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EVOLVING YOURSELF THERAPY

Practice address

3103 Wilmington Rd
New Castle, PA 16105-1131

Phone

(724) 542-8716

Fax

(724) 765-2014

NPI assigned

Oct 8, 2024

Organization subpart

No

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

Authorized official

Name

Charitylyn Bradley, LPCNPI 1457806481

Title

Owner

Phone

(724) 542-8716

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

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

• Charitylyn Bradley, LPC

  • Professional Counselor
  • Sharon, PA
  • NPI 1457806481
  Medicare reassignment NPD Authorized official
• Stephane Marie Elisco, LSW, MPA

  • Social Worker
  • New Castle, PA
  • NPI 1467421123
  NPD

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1104645019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E REYNOLDS ST",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161014747",
            "telephone_number": "724-542-8716",
            "fax_number": "724-765-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 WILMINGTON RD",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161051131",
            "telephone_number": "724-542-8716",
            "fax_number": "724-765-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVING YOURSELF THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "CHARITYLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-542-8716",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in New Castle, PA
• Providers in New Castle, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.