Organization Active NPI

Evolve Collaborative PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charlotte, NC
National Provider Identifier
1255152609
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EVOLVE COLLABORATIVE PLLC
Practice address
4824 Water Oak Rd Apt 10
Charlotte, NC 28211-2451
Phone
(704) 272-3905
NPI assigned
Oct 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Authorized official

Name
Kayla Reeve, MA, LMFTNPI 1093464240
Title
Owner/Clinical Therapist
Phone
(704) 272-3905

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4824 Water Oak Rd Apt 10
Charlotte, NC 28211-2451

Mailing address

1235 East Blvd Ste E
Charlotte, NC 28203-5876
Phone (704) 272-3905

National Provider Directory

National Provider Directory

Locations

233 S Sharon Amity Rd
Ste 202
Charlotte, NC 28211

Practitioners & affiliated clinicians

Practitioners 1

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": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1255152609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 EAST BLVD STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035876",
            "telephone_number": "704-272-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 WATER OAK RD APT 10",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112451",
            "telephone_number": "704-272-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE COLLABORATIVE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "REEVE",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "704-272-3905",
        "authorized_official_credential": "MA, LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.