Evolution Through Mind, Body, and Spirit, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EVOLUTION THROUGH MIND, BODY, AND SPIRIT, LLC

Practice address

14055 Cedar Rd Ste 200
South Euclid, OH 44118-3333

Phone

(440) 252-1063

NPI assigned

Jul 7, 2020

Organization subpart

No

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

Authorized official

Name

Nicole Dione Berry, APRN-CNPNPI 1982855714

Title

Ceo/Founder

Phone

(440) 252-1063

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

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

• Nicole Dione Berry, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • South Euclid, OH
  • NPI 1982855714
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1730707662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14055 CEDAR RD STE 200",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441183333",
            "telephone_number": "440-252-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14055 CEDAR RD STE 200",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441183333",
            "telephone_number": "440-252-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION THROUGH MIND, BODY, AND SPIRIT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-07",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "DIONE",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "440-252-1063",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Equivalent Homecare LLC
• Espy Healthcare LLC
• Essential Transport LLC
• Esteem Home Care Services, LLC
• Everjoy Adult Family Home
• Executive Living Health Services
• Fairmount Mental Wellness LLC
• Family First Home Care
• Michelle Fernando, RN, BSN, MSN
• Sonja Nicole Ferrell, LPN

• Psychiatric/Mental Health Nurse Practitioner in South Euclid, OH
• Providers in South Euclid, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.