Evolve Behavioral Health LLC.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

EVOLVE BEHAVIORAL HEALTH LLC.

Practice address

5788 Ridge Rd Ste 3
Parma, OH 44129

Phone

(440) 340-5558

Fax

(440) 340-5575

NPI assigned

Jul 30, 2018

Organization subpart

No

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

Authorized official

Name

Traci M Barnes, LCDC III

Title

Founder

Phone

(216) 387-7277

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1255819504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 RIDGE RD STE 3",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441293162",
            "telephone_number": "440-340-5558",
            "fax_number": "440-340-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5788 RIDGE RD STE 3",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44129",
            "telephone_number": "440-340-5558",
            "fax_number": "440-340-5575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5788 Ridge Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Parma",
            "state": "OH",
            "postal_code": "44129",
            "country_code": "US",
            "telephone_number": "440-340-5558",
            "fax_number": "440-340-5575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLVE BEHAVIORAL HEALTH LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "216-387-7277",
        "authorized_official_credential": "LCDC III"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384632",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Parma, OH
• Providers in Parma, OH by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.