Evolve Behavioral Health, LLC
NPI 1316708993ActiveOrganization· Nurse Practitioner, Psych/Mental Health· Florence, AL
Nurse Practitioner, Psych/Mental Health in Florence, Alabama, registered in NPPES in January 2024. The authorized official on file is Jessi Blackstock Tidwell, Co-Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1316708993 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 19, 2024 |
| Last updated in NPPES | Jul 9, 2026 |
| Certified by provider | Jul 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Psych/Mental Health Primary | 363LP0808X | — | — |
| Internal Medicine | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AL) |
|---|
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