Healthcare Provider Details

I. General information

NPI: 1336972769
Provider Name (Legal Business Name): EVOLVE COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 PUNJAB WAY STE 140
FRISCO TX
75033-1272
US

IV. Provider business mailing address

4100 LAS BRISAS DR
IRVING TX
75038-9045
US

V. Phone/Fax

Practice location:
  • Phone: 972-510-5783
  • Fax:
Mailing address:
  • Phone: 214-995-9350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TAHIRA HASSAN
Title or Position: OWNER
Credential: LPC
Phone: 214-995-9350