Organization
EVOLVE LEARNING COMMUNITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA SULLIVAN LCSW (OWNER)
(954) 440-2483
Entity
Organization
Contact information
Practice address
4758 W COMMERCIAL BLVD, TAMARAC, FL 33319-2877
(954) 440-2483
Mailing address
4758 W COMMERCIAL BLVD, TAMARAC, FL 33319-2877
(954) 440-2483
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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