Evolving Minds Therapy (Emt) LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EVOLVING MINDS THERAPY (EMT) LLC

Practice address

5516 Boulder Hwy Ste 2F
Las Vegas, NV 89122-6000

Phone

(702) 881-1234

Fax

(651) 602-3634

NPI assigned

Feb 23, 2021

Organization subpart

No

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

Authorized official

Name

Zanyae Allen, LCPC

Title

Owner/Director/Clinician

Phone

(702) 937-4848

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1285228957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 BOULDER HWY STE 2F",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891226000",
            "telephone_number": "702-881-1234",
            "fax_number": "651-602-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 BOULDER HWY STE 2F",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891226000",
            "telephone_number": "702-881-1234",
            "fax_number": "651-602-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVING MINDS THERAPY (EMT) LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-23",
        "last_updated": "2022-01-04",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ZANYAE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR/CLINICIAN",
        "authorized_official_telephone_number": "702-937-4848",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evolve Resource Management
• Evolve Wellness LLC
• Evolve Wellness LLC
• Evolve Wellness Professional Corp
• Evolving Minds Behavioral Health Services
• Samuel Ewalefo, MD
• Lindsey Ewaliko
• Barry Ewell, D.O.
• Charmaine Ewell
• Cynthia Ewell

• Professional Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.