| Evergreen Therapy Llc | |
|
709 N Foster Ave Lansing MI 48912-4305 | |
| (517) 803-0078 | |
| Not Available |
| Full Name | Evergreen Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 709 N Foster Ave, Lansing, Michigan |
| Authorized Official Name and Position | Marybeth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Therapy Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Evergreen Therapy Llc 709 N Foster Ave Lansing MI 48912-4305 Ph: (517) 803-0078 |
| NPI Number | 1598342842 |
|---|---|
| Provider Enumeration Date | 03/24/2021 |
| Last Update Date | 03/24/2021 |
| Certification Date | 03/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598342842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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