Evolution Recovery and Wellness LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EVOLUTION RECOVERY AND WELLNESS LLC

Practice address

16042 N 32ND St Ste B-13
Phoenix, AZ 85032-3806

Phone

(480) 630-4067

Fax

(480) 304-3121

NPI assigned

Sep 13, 2018

Organization subpart

No

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

Authorized official

Name

Chanda L Gonzales, LPC, LISAC, NCCNPI 1831406388

Title

Owner, Therapist

Phone

(602) 570-9964

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Chanda Lise Gonzales, LISAC, LPC

  • Professional Counselor
  • Phoenix, AZ
  • NPI 1831406388

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1760965941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16042 N 32ND ST STE B-13",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323806",
            "telephone_number": "480-630-4067",
            "fax_number": "480-304-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16042 N 32ND ST STE B-13",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323806",
            "telephone_number": "480-630-4067",
            "fax_number": "480-304-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION RECOVERY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "CHANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "602-570-9964",
        "authorized_official_credential": "LPC, LISAC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.