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Organization
EVOLVE INDIVIDUAL SERVICES, LLC
Active
Organization
EVOLVE INDIVIDUAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIERAAH MARLOW MSW (CO-OWNER)
(202) 770-6042
Entity
Organization
Contact information
Practice address
139 E CHESTNUT ST STE 204, COATESVILLE, PA 19320-3422
(202) 770-6042
Mailing address
139 E CHESTNUT ST STE 204, COATESVILLE, PA 19320-3422
(202) 770-6042
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/13/2020
Last updated
04/26/2023
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