NPIMap

Organization Active NPI

Emerge and Evolve Therapy PLLC

  • Social Worker
  • Howell, MI
National Provider Identifier
1487341848
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
EMERGE AND EVOLVE THERAPY PLLC
Practice address
4902 Chilson Rd
Howell, MI 48843-9453
Phone
(248) 385-2524
NPI assigned
Apr 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Jacquelyn Provenzola, LMSWNPI 1477114957
Title
Owner/Provider
Phone
(248) 385-2524

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
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

4902 Chilson Rd
Howell, MI 48843-9453

Mailing address

4902 Chilson Rd
Howell, MI 48843-9453

National Provider Directory

National Provider Directory

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": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1487341848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 CHILSON RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488439453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 CHILSON RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488439453",
            "telephone_number": "248-385-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGE AND EVOLVE THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "PROVENZOLA",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "248-385-2524",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.