EVOLVE HOLISTIC THERAPY LLC (NPI# 1174179311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174179311 |
| Entity Type | Organization |
| Organization Name | EVOLVE HOLISTIC THERAPY LLC |
| Other Organization Name | EVOLVE HOLISTIC THERAPY LLC |
| Practice Address |
352 Main St Durham CT 06422-1645 |
| Mailing Address |
91 Madison Springs Dr Madison CT 06443-2419 |
| Practice Telephone | 8604644600 |
| Practice Fax Number | 8604644648 |
| Mailing Telephone | 8604644600 |
| Mailing Fax Number | 8604644648 |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-09-25 |
| Authorized Official Name | ERIN PFEIFER-ANDRIN (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Telephone | 8604644600 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 225401801000123 | 05 |
| Other Name | Type Code |
|---|---|
| Evolve Holistic Therapy LLC | Other Name - Individual/Organization |
| Street Address |
352 MAIN ST |
| City | DURHAM |
| State | CT |
| Zip Code | 06422-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326698333 | Gina Barbetta | Dietitian, Registered | 352 Main St, Durham, CT 06422-1645 | 2019-09-12 |
| 1013567031 | Nourish By Gina LLC | Dietitian, Registered | 352 Main St, Durham, CT 06422-1645 | 2019-09-12 |
| 1033779533 | Christy S. Jackson, Ph.d., LLC | Psychologist | 352 Main St, Durham, CT 06422-1645 | 2019-06-17 |
| 1578029377 | Mind Body Counseling LLC | Counselor | 352 Main St, Durham, CT 06422-1645 | 2019-02-16 |
| 1598232936 | Michelle Pellin Ms Ma Lpc LLC | Community/Behavioral Health | 352 Main St, Durham, CT 06422-1645 | 2018-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790999019 | Durham Dental LLC | Dentist | 360 D Main Street, Durham, CT 06422 | 2007-05-09 |
| 1942429014 | Mhs Primary Care | Physician Assistant | 6 Main St., Durham, CT 06422 | 2007-04-25 |
| 1407490717 | Sharon Jean Koch | Social Worker | 80 Plains Rd, Unit 1, Essex, CT 06422 | 2019-10-30 |
| 1013343334 | William Allen Gillespie | Pediatrics | 256 Main St, Durham, CT 06422 | 2013-09-18 |
| 1386993574 | Brownstone Psychological Associates, LLC | Psychologist | 199 Main Street, Durham, CT 06422 | 2012-09-03 |
| 1265469068 | Bradford W Wilkinson | Family Medicine | 6 Main St, Durham, CT 06422 | 2006-06-27 |
| 1851640148 | Debra Shepard Nelson | Psychologist | 199 Main Street, Durham, CT 06422-0002 | 2012-09-03 |
| 1457774978 | Karen Otte | Social Worker | 525 New Haven Rd., Durham, CT 06422-0236 | 2014-02-04 |
| 1396746400 | Amit Patel | Dentist | 28 Elihu Dr, Durham, CT 06422-1025 | 2005-08-10 |
| 1730458068 | Diane Adele Mount Desroches | Registered Nurse | 459r Wallingford Rd, Durham, CT 06422-1124 | 2011-12-15 |
| Find all providers in zip 06422 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184657 | Delia Hearon | Social Worker | 100 Village Circle Way Apt 216, Durham, NC 27713-6131 | 2020-11-05 |
| 1750980256 | Victoria Snow | Social Worker | 504 E Pettigrew St Apt 449, Durham, NC 27701-3888 | 2020-10-26 |
| 1053910984 | Tedra Cook | Social Worker | 313 Chestnut Oak Pl, Durham, NC 27704-5196 | 2020-10-21 |
| 1821695644 | Adam Tannenbaum | Social Worker | 1821 Hillandale Rd Ste 1b-154, Durham, NC 27705-2659 | 2020-10-05 |
| 1831706373 | Elena Plocek | Social Worker | 2617 Farthing St, Durham, NC 27704-4203 | 2020-09-29 |
| 1225643323 | Aisha S Lewis | Social Worker | 79 Willow Bridge Dr, Durham, NC 27707-5457 | 2020-09-15 |
| 1639781354 | Inner Knowing Clinical Therapy LLC | Social Worker | 117 Brown Rd, Durham, ME 04222-5213 | 2020-08-24 |
| 1730791765 | Katrina P Martin | Social Worker | 2511 N Roxboro St, Durham, NC 27704-4347 | 2020-08-20 |
| 1194337758 | Ashley Esry | Social Worker | 1728 Euclid Rd, Durham, NC 27713-2415 | 2020-08-17 |
| 1265050124 | Amber Cox | Social Worker | 3622 Lyckan Pkwy Ste 5007, Durham, NC 27707-2539 | 2020-07-08 |
| Find all providers in DURHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.