NPIMap

Organization Active NPI

Evolve Counseling & Holistic Wellness LLC

  • Counselor
  • Lansing, MI
National Provider Identifier
1689122830
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
EVOLVE COUNSELING & HOLISTIC WELLNESS LLC
Practice address
513 Hume Blvd
Lansing, MI 48917-4247
Phone
(517) 712-9736
NPI assigned
Sep 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Authorized official

Name
Kelly Roberson, LPC
Title
Owner
Phone
(517) 712-9736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

513 Hume Blvd
Lansing, MI 48917-4247

Mailing address

513 Hume Blvd
Lansing, MI 48917-4247
Phone (517) 712-9736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240110002041 MI Part B Supplier - Clinic/Group Practice 0648621029 Practice locations: Lansing, MI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1689122830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 HUME BLVD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174247",
            "telephone_number": "517-712-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 HUME BLVD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174247",
            "telephone_number": "517-712-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE COUNSELING & HOLISTIC WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-712-9736",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.