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EVERGREEN PSYCHOLOGICAL SERVICES NPI 1184376048


NPI Information

NPI: 1184376048
Provider Name: EVERGREEN PSYCHOLOGICAL SERVICES
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
1930 BLACK LAKE BLVD SW # 102
OLYMPIA, WA
ZIP 98512
Phone: (360) 347-6172
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EVERGREEN PSYCHOLOGICAL SERVICES is a clinical neuropsychologist in Olympia, WA. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. EVERGREEN PSYCHOLOGICAL SERVICES NPI is 1184376048. The provider is registered as an organization entity type.

The provider's business location address is:

1930 BLACK LAKE BLVD SW # 102
OLYMPIA, WA
ZIP 98512-651
Phone: (360) 347-6172
Fax: (360) 350-4619

The provider's authorized official is Evan Lima .
The authorized official title is Owner and has the following contact phone number (360) 347-6172.

The enumeration date for this NPI number is 1/21/2022 and was last updated on 1/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0850XClinic/CenterAdult Mental HealthNo
2261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
3103G00000XClinical NeuropsychologistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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