# EVOLVE COMMUNITY CONSULTING

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Body Vault LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417717141
- **Authorized official:** MIAUNA KINNARD (CASE MANAGER/PROGRAM COORDINATOR)
- **Authorized official phone:** (502) 712-7443

## Contact information

- **Practice address:** 3423 STONY SPRING CIR, LOUISVILLE, KY 40220-5437
- **Practice address phone:** (502) 709-9589
- **Mailing address:** 3423 STONY SPRING CIR, LOUISVILLE, KY 40220-5437
- **Mailing address phone:** (502) 709-9589

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 251B00000X | Case Management Agency | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 324500000X | Substance Abuse Rehabilitation Facility | — | NULL | — |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | — | NULL | — |

## Other

- **Enumeration date:** 03/20/2024
- **Last updated:** 08/16/2026