Provider Demographics
NPI:1790495620
Name:EVERGREEN COUNSELING LLC
Entity Type:Organization
Organization Name:EVERGREEN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:STENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:603-381-1661
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05047-0356
Mailing Address - Country:US
Mailing Address - Phone:802-281-3607
Mailing Address - Fax:
Practice Address - Street 1:222 HOLIDAY DR STE 23
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-2098
Practice Address - Country:US
Practice Address - Phone:802-281-3607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty