Evolution Mind, LLC
NPI #1912428905 in Maplewood, New Jersey
Provider Information
- NPI Number
- 1912428905
- Entity Type
- Organization
- Organization Name
- Evolution Mind, LLC
- Primary Specialty
- Clinic/Center - Mental Health (Including Community Mental Health Center)
- Enumeration Date
- Jun 29, 2017
- Last Updated
- Oct 23, 2017
Practice Location
- Address
- 2130 MILLBURN AVE STE D2
- City
- Maplewood
- State
- New Jersey
- ZIP Code
- 07040-3749
- Phone
- (973) 801-1801
Authorized Official
- Name
- KIRA BASKERVILLE-WILLIAMS, MSW, LCSW, ED.S
- Title
- CO-OWNER
- Phone
- (973) 801-1801
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
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