NPIMap

Organization Active NPI

Evolve Psych Group, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waxhaw, NC
National Provider Identifier
1356088389
Registry record updated May 20, 2022
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 PSYCH GROUP, PLLC
Practice address
1109 Meadowlark LN
Waxhaw, NC 28173-7501
Phone
(631) 553-9460
NPI assigned
May 20, 2022
Last updated
May 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

Name
Ms. Allison Becker, LCMHCENPI 1003258880
Title
President
Phone
(631) 553-9460

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

1109 Meadowlark LN
Waxhaw, NC 28173-7501

Mailing address

1109 Meadowlark LN
Waxhaw, NC 28173-7501
Phone (631) 553-9460

National Provider Directory

National Provider Directory

Locations

10706 Sikes Pl
Ste 275
Charlotte, NC 28277
Phone (704) 577-4071

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1356088389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 MEADOWLARK LN",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737501",
            "telephone_number": "631-553-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 MEADOWLARK LN",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737501",
            "telephone_number": "631-553-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE PSYCH GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-553-9460",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCMHCE"
    },
    "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 Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.