Resonant Evolution Llc

LBN: Resonant Evolution Llc
Resonant Evolution Llc is an health care organization with primary practice located at 440 S Main St Suite A, Fort Worth TX 76104-2400. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as the primary health care specialty. Resonant Evolution Llc can be contacted via phone (817) 368-3875, or through Phoenix, Vida June via phone (817) 368-3875.

Contact Information

Primary practice address
440 S Main St Suite A Fort Worth TX 76104-2400
Phone: (817) 368-3875
Fax: (682) 841-1138
Website:
Map and Directions
Authorized official contact:
Name: Phoenix, Vida June Licensed Professional Counselor (LPC)
Phone: (817) 368-3875

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 16923 Texas

Profile Details

NPI number 1174953483
LBN Legal business name Resonant Evolution Llc
DBA Doing business as
Authorized official Phoenix, Vida June Licensed Professional Counselor (LPC)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 22nd, 2013
Last updated Nov 22nd, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174953483 NPPES
Texas MEDICAID 144980302

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