Evolution Mind, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Maplewood, New Jersey
1912428905- Practice location
- 2130 Millburn Ave Ste D2, Maplewood, NJ 07040-3749
- Phone
- 973-801-1801
- Fax
- 908-964-0809
- Last updated
- October 23, 2017
Evolution Mind, LLC is a healthcare organization based in Maplewood, NJ. Evolution Mind, LLC practices in Maplewood, NJ. The NPI Number for Evolution Mind, LLC is 1912428905. The current practice location address for Evolution Mind, LLC is 2130 Millburn Ave Ste D2, Maplewood, NJ 07040-3749 and can be reached out via phone at 973-801-1801 and via fax at 908-964-0809.
Provider Profile Details
- NPI Number
- 1912428905
- Provider Name
- Evolution Mind, LLC
- Provider Entity Type
- Organization
- Address
- 2130 Millburn Ave Ste D2, Maplewood, NJ 07040-3749
- Phone Number
- 973-801-1801
- Fax Number
- 908-964-0809
- Primary Taxonomy
- Clinic/Center, Mental Health (Including Community Mental Health Center) · 261QM0801X
- Organization Subpart
- No
- Authorized Official
- Kira Baskerville-Williams, MSW, LCSW, EDS · Co-Owner · 973-801-1801
- Provider Enumeration Date
- June 29, 2017
- Last Update Date
- October 23, 2017
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2130 Millburn Ave Ste D2
Maplewood, NJ 07040-3749 - City
- Maplewood
- State
- New Jersey
- Zip
- 07040-3749
- Phone Number
- 973-801-1801
- Fax Number
- 908-964-0809
Provider Business Mailing Address Details
- Address
- 1286 Marcella Dr
Union, NJ 07083-6243 - City
- Union
- State
- NJ
- Zip
- 07083-6243
- Phone Number
- 973-801-1801
License Information
- Taxonomy
- Clinic/Center, Mental Health (Including Community Mental Health Center) · 261QM0801X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Evolution Mind, LLC?
The NPI number of Evolution Mind, LLC is 1912428905. It was assigned on June 29, 2017 and is currently active in the NPPES registry.
What is the specialty of Evolution Mind, LLC?
Evolution Mind, LLC is registered under the primary taxonomy Clinic/Center, Mental Health (Including Community Mental Health Center) (code 261QM0801X).
Where does Evolution Mind, LLC practice?
The practice location is 2130 Millburn Ave Ste D2, Maplewood, NJ 07040-3749. The office can be reached at 973-801-1801 (phone) or 908-964-0809 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1912428905 directly on the NPPES registry website.