Provider Demographics
NPI:1477433373
Name:EVOLUTIONARY WELLNESS LLC
Entity type:Organization
Organization Name:EVOLUTIONARY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:732-996-5632
Mailing Address - Street 1:1913 ATLANTIC AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1913 ATLANTIC AVE STE 208
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1067
Practice Address - Country:US
Practice Address - Phone:732-996-5632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health