Evolve Psychiatry and Counseling PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EVOLVE PSYCHIATRY AND COUNSELING PLLC

Practice address

111 Simmons Rd
South Portland, ME 04106-6509

Phone

(207) 272-5647

NPI assigned

May 15, 2023

Organization subpart

No

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

Authorized official

Name

Paula A GentileNPI 1952071656

Title

Owner

Phone

(207) 272-5647

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Practitioners 1

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

• Paula Gentile, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, ME
  • NPI 1952071656
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1245921964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SIMMONS RD",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066509",
            "telephone_number": "207-272-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SIMMONS RD",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066509",
            "telephone_number": "207-272-5647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 North St",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "NH",
            "postal_code": "030554020",
            "country_code": "US",
            "telephone_number": "207-272-5647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLVE PSYCHIATRY AND COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-272-5647"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in South Portland, ME
• Providers in South Portland, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.