Healthcare Provider Details

I. General information

NPI: 1356896393
Provider Name (Legal Business Name): EVOLVE IN NATURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 28TH ST STE 205
BOULDER CO
80303-1756
US

IV. Provider business mailing address

1200 28TH ST STE 205
BOULDER CO
80303-1756
US

V. Phone/Fax

Practice location:
  • Phone: 303-668-7255
  • Fax:
Mailing address:
  • Phone: 303-668-7255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHELLY FROEHLICH
Title or Position: PRESIDENT
Credential: MA
Phone: 303-993-7787