Evolving Lives LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EVOLVING LIVES LLC

Practice address

1990 Louisville Rd Ste 107
Bowling Green, KY 42101-1202

Phone

(270) 495-1222

Fax

(859) 209-6504

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Adria Whitlow, LCSWNPI 1770716532

Title

Owner

Phone

(270) 495-1222

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adria Chanell Whitlow, MSW, LCSW-S

  • Clinical Social Worker
  • Bowling Green, KY
  • NPI 1770716532
  Medicare reassignment NPD Authorized official
• Taylor Duncan, LPCC

  • Professional Counselor
  • Bowling Green, KY
  • NPI 1083061394
  Medicare reassignment NPD
• Dawn Shannon, CSW

  • Clinical Social Worker
  • Bowling Green, KY
  • NPI 1154061489
  NPD (past)

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1477144046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 LOUISVILLE RD STE 107",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011202",
            "telephone_number": "270-495-1222",
            "fax_number": "859-209-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 LOUISVILLE RD STE 107",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011202",
            "telephone_number": "270-495-1222",
            "fax_number": "859-209-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVING LIVES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "WHITLOW",
        "authorized_official_first_name": "ADRIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-495-1222",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100720500",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100682470",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100811550",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keana Denise Evans, RBT
• Keenah Evans, KCSA
• Evergreen Presbyterian Ministries, Inc. (Evergreen East Kentucky Services)
• Donna Carol Everly, MAE, DI
• Emma G Evers, RBT
• Extendicare Homes, Inc. (Medco Center of Bowling Green)
• Manuel A Fadul Noy
• Fairview Chiropractic Inc.
• Faith Harbor
• Faith Harbor

• Clinical Social Worker in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.