| Evergreen Counseling Services, Llc | |
|
203 N Pine St Wapello IA 52653-1241 | |
| (563) 293-6205 | |
| Not Available |
| Full Name | Evergreen Counseling Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 203 N Pine St, Wapello, Iowa |
| Authorized Official Name and Position | Lindsey Lundry (OWNER) |
| Authorized Official Contact | 5632936205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Counseling Services, Llc 203 N Pine St Wapello IA 52653-1241 Ph: (563) 293-6205 | Evergreen Counseling Services, Llc 203 N Pine St Wapello IA 52653-1241 Ph: (563) 293-6205 |
| NPI Number | 1790540854 |
|---|---|
| Provider Enumeration Date | 02/19/2024 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/18/2024 |
| Medicare PECOS PAC ID | 3476993403 |
|---|---|
| Medicare Enrollment ID | O20240424002714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790540854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lindsey Ann Lundry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689940611 PECOS PAC ID: 1456770312 Enrollment ID: I20240424002851 |
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