Organization · Type 2 NPI

Evolve Behavioral Health, LLC

Psychiatric/Mental Health Nurse Practitioner · Florence, AL

NPI number 1316708993 Active

Practice location

2904 Mall Rd
Florence, AL 35630-1641

Fax (949) 695-4340

Specialties and licenses

Taxonomy	Code	License
Internal Medicine Physician	207R00000X	None listed
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	None listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

5 other providers at this address

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NPI record

NPI: 1316708993
Entity type: Organization (Type 2)
Issued: Jan 19, 2024
Last updated: Jul 9, 2026
Status: Active

Other names

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Evolve Behavioral Health · doing business as
Evolve Behavioral Health · doing business as

Authorized official

Jessi Blackstock Tidwell
Co-Owner
(256) 767-3330

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1316708993

Evolve Behavioral Health, LLC's National Provider Identifier is 1316708993, issued on Jan 19, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Florence, AL. The record was last updated on Jul 9, 2026.