MEDICARE: EVOLVE COMMUNITY CONSULTING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	101YM0800X	Mental Health Counselor
3	3245S0500X	Children's Substance Abuse Rehabilitation Facility
4	1041C0700X	Clinical Social Worker
5	324500000X	Substance Abuse Rehabilitation Facility
6	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1417717141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVOLVE COMMUNITY CONSULTING

Provider Business Mailing Address
First Line	:	3423 STONY SPRING CIR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-5437
Country	:	US
Telephone Number	:	502-709-9589
Fax Number	:

Provider Business Practice Location Address
First Line	:	3423 STONY SPRING CIR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-5437
Country	:	US
Telephone Number	:	502-709-9589
Fax Number	:

Authorized Official
Title or Position	:	CASE MANAGER/PROGRAM COORDINATOR
Name	:	MIAUNA KINNARD
Credential	:
Telephone Number	:	502-712-7443

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	01/13/2026

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