# LIFE EVOLUTION MENTAL HEALTH COUNSELING, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750286548
- **Authorized official:** TAMMY MYERS LMHC, CASAC (OWNER)
- **Authorized official phone:** (518) 309-2299

## Contact information

- **Practice address:** 1139 LAURAL LN, MALTA, NY 12020-4399
- **Practice address phone:** (518) 309-2299
- **Mailing address:** 7 KENDALL WAY STE 230, MALTA, NY 12020-4399
- **Mailing address phone:** (518) 309-2299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |

## Other

- **Enumeration date:** 10/12/2026
- **Last updated:** 10/12/2026