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General NPI Number Information
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NPI Number | 1184422214
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Entity Type | Organization
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Legal Business Name | NEED TO EVOLVE, INC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 1079 BARON DR
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City | BRYN MAWR
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State | PA
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Zip | 19010-1836
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Country | US
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Telephone | 267-638-8899
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Fax |
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Provider Business Mailing Address
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Address Line | 425 FAYETTE ST UNIT 614
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-5429
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Country | US
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Telephone | 267-638-8899
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNY STAROSTA
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Credential | PHD
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Telephone | 267-638-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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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 | 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 #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent 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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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