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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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