Provider Demographics
NPI:1124639745
Name:EVOLVE PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:EVOLVE PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSMIRE-POLICARI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:321-693-7428
Mailing Address - Street 1:2933 ENGLEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3978
Mailing Address - Country:US
Mailing Address - Phone:321-693-7428
Mailing Address - Fax:
Practice Address - Street 1:120 PROVIDENCE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2273
Practice Address - Country:US
Practice Address - Phone:919-377-9763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty