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General NPI Number Information
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NPI Number | 1063235604
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Entity Type | Organization
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Legal Business Name | EVOLVING CHANGES COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 18600 FLORENCE ST STE C23
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City | ROSEVILLE
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State | MI
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Zip | 48066-6600
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Country | US
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Telephone | 313-888-7863
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Fax |
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Provider Business Mailing Address
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Address Line | 19074 LISTER AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021-2740
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Country | US
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Telephone | 313-888-7863
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAKEITA COBB
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Credential | LMSW
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Telephone | 313-805-0384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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