Healthcare Provider Details

I. General information

NPI: 1508687765
Provider Name (Legal Business Name): EVOLVEDBH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 08/21/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85257-3429
US

IV. Provider business mailing address

1375 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85257-3429
US

V. Phone/Fax

Practice location:
  • Phone: 480-877-9284
  • Fax:
Mailing address:
  • Phone: 480-877-9284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN BREWER
Title or Position: CHIEF CLINICAL OFFICER
Credential: DNP, PMHNP
Phone: 480-877-9284