Provider Demographics
NPI:1275303752
Name:EVERGREEN COUNSELING
Entity Type:Organization
Organization Name:EVERGREEN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:209-628-9691
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-0062
Mailing Address - Country:US
Mailing Address - Phone:209-742-5080
Mailing Address - Fax:
Practice Address - Street 1:5079 HIGHWAY 140
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-2434
Practice Address - Country:US
Practice Address - Phone:209-742-5080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty