Healthcare Provider Details

I. General information

NPI: 1538077300
Provider Name (Legal Business Name): EVOKE PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 E MICHIGAN AVE STE 400N
KALAMAZOO MI
49007-3926
US

IV. Provider business mailing address

161 E MICHIGAN AVE STE 400N
KALAMAZOO MI
49007-3926
US

V. Phone/Fax

Practice location:
  • Phone: 269-929-7486
  • Fax:
Mailing address:
  • Phone: 269-929-7486
  • 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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. LORI GUIDONE
Title or Position: OWNER
Credential: LPC
Phone: 269-929-7486