Evolve Behavioral Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0056 Issued in CT

Legal business name

EVOLVE BEHAVIORAL INC.

Practice address

146 Elm St
Cheshire, CT 06410-2808

Phone

(203) 439-7545

NPI assigned

Jan 30, 2018

Organization subpart

No

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

Authorized official

Name

Carla Martin, LCSWNPI 1669685145

Title

President

Phone

(203) 439-7545

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Evolving LLC

  • Clinical Social Worker
  • Cheshire, CT
  • NPI 1821814724
  NPPES parent name

Practitioners 1

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

• Carla Lynn Martin, LCSW

  • Clinical Social Worker
  • Cheshire, CT
  • NPI 1669685145
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1639677149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 FORGE DR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013246",
            "telephone_number": "203-710-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 ELM ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102808",
            "telephone_number": "203-439-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE BEHAVIORAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-30",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-439-7545",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "0056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008030935",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonio R Esposito, RPT
• Lisa Esposito
• Samantha Estelle-Abate, MSN, APRN, FNP-BC
• Elizabeth A Euley, RPT
• Jennifer R Evans, LCSW, MSW
• Evolving LLC
• Eye & Vision Clinic
• Eye Center of Southern Connecticut, P.C.
• Rebecca Verosloff Fantozzi, DMD
• Todd Faraoni, LPCA, MA

• Clinical Social Worker in Cheshire, CT
• Providers in Cheshire, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.