Provider Demographics
NPI:1275361479
Name:EVOLVE MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:EVOLVE MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH
Authorized Official - Phone:402-631-1836
Mailing Address - Street 1:1106 CHERRYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-1677
Mailing Address - Country:US
Mailing Address - Phone:402-631-1836
Mailing Address - Fax:
Practice Address - Street 1:415 S MAIN ST STE 309
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4304
Practice Address - Country:US
Practice Address - Phone:605-277-8382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty