NPIMap

Organization Active NPI

Evolve Therapuetic Behavioral Health and Wellness Services

  • Community/Behavioral Health Agency
  • Bowie, MD
National Provider Identifier
1538433313
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LC4137 Issued in MD
Legal business name
EVOLVE THERAPUETIC BEHAVIORAL HEALTH AND WELLNESS SERVICES
Practice address
16208 Penterra Way
Bowie, MD 20716-1919
Phone
(301) 996-1677
NPI assigned
Feb 27, 2012
Last updated
Apr 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Authorized official

Name
Ms. Jacqueline Doloris Hamilton, LCPCNPI 1629551239
Title
Executive Director/Owner
Phone
(301) 996-1677

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
Community/Behavioral Health Agency 251S00000X LC4137 MD Primary

Addresses

Primary practice location

16208 Penterra Way
Bowie, MD 20716-1919

Mailing address

16208 Penterra Way
Bowie, MD 20716-1919
Phone (301) 996-1677

National Provider Directory

National Provider Directory
Tax ID family
Evolve Therapuetic Behavioral Health and Wellness Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1538433313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16208 PENTERRA WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161919",
            "telephone_number": "301-996-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16208 PENTERRA WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161919",
            "telephone_number": "301-996-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE THERAPUETIC BEHAVIORAL HEALTH AND WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "DOLORIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/OWNER",
        "authorized_official_telephone_number": "301-996-1677",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "LC4137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.