NPIMap

Organization Active NPI

Evolve Professional Counseling LLC

  • Community/Behavioral Health Agency
  • Tahlequah, OK
National Provider Identifier
1558728923
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
4790 Issued in OK
Legal business name
EVOLVE PROFESSIONAL COUNSELING LLC
Practice address
1140 Mayberry Dr
Tahlequah, OK 74464-4603
Phone
(918) 718-4475
NPI assigned
Jan 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Authorized official

Name
Stacy Culwell Hall, M.ED. LPCNPI 1831402163
Title
Owner/Director
Phone
(918) 457-0089

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 4790 OK Primary

Addresses

Primary practice location

1140 Mayberry Dr
Tahlequah, OK 74464-4603

Mailing address

1140 Mayberry Dr
Tahlequah, OK 74464-4603
Phone (918) 718-4475

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452816000000",
    "number": "1558728923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 MAYBERRY DR",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644603",
            "telephone_number": "918-718-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 MAYBERRY DR",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644603",
            "telephone_number": "918-718-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE PROFESSIONAL COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "CULWELL",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "918-457-0089",
        "authorized_official_credential": "M.ED. LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "4790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.