| Evergreen Therapy & Wellness | |
|
206-10 Southwind Place Suite 2c Manhattan KS 66503 | |
| (785) 477-4400 | |
| Not Available |
| Full Name | Evergreen Therapy & Wellness |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 206-10 Southwind Place Suite 2c, Manhattan, Kansas |
| Authorized Official Name and Position | Kassandra Moran (OWNER/THERAPIST) |
| Authorized Official Contact | 7854774400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Therapy & Wellness 206-10 Southwind Place Suite 2c Manhattan KS 66503 Ph: (785) 477-4400 | Evergreen Therapy & Wellness 206-10 Southwind Place Suite 2c Manhattan KS 66503 Ph: (785) 477-4400 |
| NPI Number | 1336858190 |
|---|---|
| Provider Enumeration Date | 11/21/2022 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/04/2024 |
| Medicare PECOS PAC ID | 2365978665 |
|---|---|
| Medicare Enrollment ID | O20241210003519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336858190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Jennifer S Colby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013172634 PECOS PAC ID: 5193967677 Enrollment ID: I20130813000358 |
| Provider Name | Ashlee Lauren Buss |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013697317 PECOS PAC ID: 7719413012 Enrollment ID: I20241210003579 |
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