| Evergreen Therapy, Pllc | |
|
7514 Highway 107 Sherwood AR 72120-7212 | |
| (501) 392-6681 | |
| Not Available |
| Full Name | Evergreen Therapy, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7514 Highway 107, Sherwood, Arkansas |
| Authorized Official Name and Position | Jobeth Musick (MEMBER) |
| Authorized Official Contact | 5014254039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Therapy, Pllc 1101 Winnebago Dr North Little Rock AR 72116-4350 Ph: (501) 425-4039 | Evergreen Therapy, Pllc 7514 Highway 107 Sherwood AR 72120-7212 Ph: (501) 392-6681 |
| NPI Number | 1891494779 |
|---|---|
| Provider Enumeration Date | 02/28/2023 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891494779 | NPI | - | NPPES |
| 1659722528 | Medicaid | AR | |
| 1306194485 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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