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Contact Information

EVOLVE FAMILY THERAPY LLC
333 N RANDALL RD # 105-B
SAINT CHARLES, IL60174-1573
 Phone: 845-857-7840
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counseling

103TC1900X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for EVOLVE FAMILY THERAPY LLC · (Female)

NPI Number 1245997832
Status Active
Credentials
Entity Individual
Enumeration date 11/18/2021
Last updated 12/09/2025 - About 6 months ago
Sole proprietor 1 Not specified
Identifiers
  • IL Medicaid 1437614666
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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