Evolving Self Integral Counseling, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

EVOLVING SELF INTEGRAL COUNSELING, LLC

Practice address

2232 NW Everett St Apt 21
Portland, OR 97210-5516

Phone

(503) 310-6276

NPI assigned

Jul 28, 2023

Organization subpart

No

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

Authorized official

Name

Palma Azucena Corral Sotelo, PCA

Title

Professional Counseling Associate

Phone

(503) 310-6276

Specialties & licenses 1

Addresses

Other names 1

• Evolving Self Integral Counseling Doing business as

Practitioners 1

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

• Palma Azucena Corral Sotelo, PCA

  • Professional Counselor
  • Portland, OR
  • NPI 1518647965
  NPD

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1144901513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 NW EVERETT ST APT 21",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105516",
            "telephone_number": "503-310-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 NW EVERETT ST APT 21",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105516",
            "telephone_number": "503-310-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVING SELF INTEGRAL COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "CORRAL SOTELO",
        "authorized_official_first_name": "PALMA AZUCENA",
        "authorized_official_title_or_position": "PROFESSIONAL COUNSELING ASSOCIATE",
        "authorized_official_telephone_number": "503-310-6276",
        "authorized_official_credential": "PCA"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolving Self Integral Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evoke Therapy LLC
• Evolution Healthcare, Rehab., & Fitness
• Evolution Therapeutics LLC
• Evolve and Elevate, LLC
• Evolve Wellness
• Collette Marie Evrard, NP
• Lawrence Raj Ewald
• Emma Ewel, LMFT
• Elise Nicole Ewens, DO
• Ebe A Ewere, MD

• Adult Mental Health Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.