Organization
EVOLVE BEHAVIORAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA MARTIN LCSW (PRESIDENT)
(203) 439-7545
Entity
Organization
Contact information
Practice address
146 ELM ST, CHESHIRE, CT 06410-2808
(203) 439-7545
Mailing address
141 FORGE DR, AVON, CT 06001-3246
(203) 710-4265
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0056
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008030935
—
CT
Enumeration date
01/30/2018
Last updated
11/26/2024
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