Healthcare Provider Details

I. General information

NPI: 1396667887
Provider Name (Legal Business Name): EVOLVE MENTAL HEALTH AWARENESS & MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29532 SOUTHFIELD RD STE 115
SOUTHFIELD MI
48076-2023
US

IV. Provider business mailing address

29532 SOUTHFIELD RD STE 115
SOUTHFIELD MI
48076-2023
US

V. Phone/Fax

Practice location:
  • Phone: 313-753-8927
  • Fax:
Mailing address:
  • Phone: 313-753-8927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELLE WILLIAMS
Title or Position: PMHNP-BC
Credential:
Phone: 313-753-8927