Healthcare Provider Details
I. General information
NPI: 1548104904
Provider Name (Legal Business Name): EVOLVE PSYCHOTHERAPY & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3209 INGERSOLL AVE STE 100
DES MOINES IA
50312-3920
US
IV. Provider business mailing address
245 NW COPPERLEAF CT
WAUKEE IA
50263-2909
US
V. Phone/Fax
- Phone: 515-461-1569
- Fax: 515-207-1705
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRIDGETTE
C
HENSLEY
Title or Position: OWNER/PRESIDENBT
Credential: PSY.D.
Phone: 608-780-6714