Provider Demographics
NPI:1730903352
Name:EVOKE COUNSELING AND WELLNESS
Entity type:Organization
Organization Name:EVOKE COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-270-3005
Mailing Address - Street 1:700 W 23RD ST STE 28C
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3932
Mailing Address - Country:US
Mailing Address - Phone:850-270-3005
Mailing Address - Fax:
Practice Address - Street 1:700 W 23RD ST STE 28C
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3932
Practice Address - Country:US
Practice Address - Phone:850-270-3005
Practice Address - Fax:850-616-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty