Organization
EVOLVE YOURSELF INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TISHLINN S FOUNTAIN LPC (PRESIDENT)
(504) 312-9388
Entity
Organization
Contact information
Practice address
1980 POST OAK BLVD STE 100, HOUSTON, TX 77056-3838
(504) 619-8966
(504) 910-1020
Mailing address
PO BOX 2717, GRETNA, LA 70054-2717
(504) 619-8966
(504) 910-1020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/07/2022
Last updated
04/11/2022
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