| Evergreen Psychological Services Llc | |
|
5724 Falls Rd Baltimore MD 21209-3708 | |
| (410) 336-5329 | |
| (410) 878-2783 |
| Full Name | Evergreen Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5724 Falls Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Paul Patrick Giggey (DIRECTOR) |
| Authorized Official Contact | 4103365329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Psychological Services Llc Po Box 16277 Baltimore MD 21210-0277 Ph: (410) 336-5329 | Evergreen Psychological Services Llc 5724 Falls Rd Baltimore MD 21209-3708 Ph: (410) 336-5329 |
| NPI Number | 1164661799 |
|---|---|
| Provider Enumeration Date | 02/04/2009 |
| Last Update Date | 02/19/2023 |
| Certification Date | 02/19/2023 |
| Medicare PECOS PAC ID | 3678619384 |
|---|---|
| Medicare Enrollment ID | O20091012000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164661799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 04688 (Maryland) | Secondary |
| 103TC0700X | Psychologist - Clinical | 04688 (Maryland) | Primary |
| Provider Name | Paul P Giggey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629272711 PECOS PAC ID: 6305932179 Enrollment ID: I20071010000389 |
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