EVERGREEN WELLNESS LLC NPI 1497660211

NPI Information

  • NPI: 1497660211
  • Provider Name: EVERGREEN WELLNESS LLC
  • Classification: Social Worker - 104100000X
  • Entity Type: Organization
  • Address: 2583 GATEWAY DR STE 140
    STATE COLLEGE, PA
    ZIP 16801
  • Phone: (814) 303-2005

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NPI Details

EVERGREEN WELLNESS LLC is a social worker in State College, PA. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. EVERGREEN WELLNESS LLC NPI is 1497660211. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2583 GATEWAY DR STE 140
STATE COLLEGE, PA
ZIP 16801-098
Phone: (814) 303-2005

The provider's authorized official is Jade Moore Stephens .
The authorized official title is Owner and has the following contact phone number (814) 303-2005.

The enumeration date for this NPI number is 8/17/2026 and was last updated on 8/17/2026.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2104100000XSocial WorkerYes
31041C0700XSocial WorkerClinicalNo
4363LP0808XNurse PractitionerPsychiatric/Mental HealthNo

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: 11/21/2025

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