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General NPI Number Information
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NPI Number | 1669026324
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Entity Type | Organization
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Legal Business Name | EVOLVE THERAPY LLC
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 7855 ARGYLE FOREST BLVD STE 404
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City | JACKSONVILLE
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State | FL
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Zip | 32244-7702
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Country | US
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Telephone | 904-528-0248
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Fax |
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Provider Business Mailing Address
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Address Line | 786 BLANDING BLVD STE 120
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City | ORANGE PARK
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State | FL
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Zip | 32065-6728
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Country | US
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Telephone | 904-385-9240
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER, PSYCHOTHERAPIST
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Name | PETERGAY STERLING
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Credential | PMHNP-BC, LMHC
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Telephone | 904-528-0248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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