Healthcare Provider Details

I. General information

NPI: 1699120816
Provider Name (Legal Business Name): EVOLVE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227500 RIB MOUNTAIN DR STE 101
RIB MOUNTAIN WI
54401-5052
US

IV. Provider business mailing address

4855 N 53RD AVE
WAUSAU WI
54401-9786
US

V. Phone/Fax

Practice location:
  • Phone: 920-843-0213
  • Fax: 715-600-9031
Mailing address:
  • Phone: 920-843-0213
  • Fax: 715-600-9031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5581125
License Number StateWI

VIII. Authorized Official

Name: JAN SPANGLER
Title or Position: OWNER/LPC
Credential:
Phone: 715-298-6201