Evolve Counseling & Consultationllc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002512 Issued in CT

Legal business name

EVOLVE COUNSELING & CONSULTATIONLLC

Practice address

65 S Colony St
Wallingford, CT 06492-4150

Phone

(413) 210-7728

NPI assigned

Dec 11, 2017

Organization subpart

No

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

Authorized official

Name

Melissa Gilmore, LPC

Title

Owner

Phone

(413) 210-7728

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1255846457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 HIGHLAND AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064925605",
            "telephone_number": "413-210-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 S COLONY ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924150",
            "telephone_number": "413-210-7728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 N Main St",
            "address_purpose": "LOCATION",
            "city": "Branford",
            "state": "CT",
            "postal_code": "064053032",
            "country_code": "US",
            "telephone_number": "413-210-7728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLVE COUNSELING & CONSULTATIONLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-210-7728",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.