Organization Active NPI

Change to Evolve LLC

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1316638893
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CHANGE TO EVOLVE LLC
Practice address
2 Park Ave FL 20
New York, NY 10016-9306
Phone
(917) 940-6607
NPI assigned
May 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
John SaundersNPI 1093185852
Title
Owner
Phone
(917) 940-6607

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 CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2 Park Ave FL 20
New York, NY 10016-9306

Mailing address

2 Park Ave FL 20
New York, NY 10016-9306
Phone (917) 940-6607

National Provider Directory

National Provider Directory

Locations

2 Park Ave
Fl 20
New York, NY 10016
Phone (347) 705-3007

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": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1316638893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARK AVE FL 20",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169306",
            "telephone_number": "917-940-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PARK AVE FL 20",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169306",
            "telephone_number": "917-940-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE TO EVOLVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-940-6607"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.