Provider Demographics
NPI:1730419656
Name:EVOL CONSULTING LLC
Entity type:Organization
Organization Name:EVOL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WRIGHTSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-614-6670
Mailing Address - Street 1:2401 LAKE ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3872
Mailing Address - Country:US
Mailing Address - Phone:402-614-6670
Mailing Address - Fax:402-614-6676
Practice Address - Street 1:2401 LAKE ST
Practice Address - Street 2:SUITE 140
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-3872
Practice Address - Country:US
Practice Address - Phone:402-614-6670
Practice Address - Fax:402-614-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025810800Medicaid
NE10025810800Medicaid