Evergreen Psychological Services

LBN: Evergreen Psychological Services
Evergreen Psychological Services is an health care organization with primary practice located at 313 College Ave , Oskaloosa IA 52577-1700. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as the primary health care specialty. Evergreen Psychological Services can be contacted via phone (641) 670-0388, or through Potter, Thomas via phone (641) 670-0388.

Contact Information

Primary practice address
313 College Ave Oskaloosa IA 52577-1700
Phone: (641) 670-0388
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Potter, Thomas PH.D.
Phone: (641) 670-0388

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X

Profile Details

NPI number 1104148485
LBN Legal business name Evergreen Psychological Services
DBA Doing business as
Authorized official Potter, Thomas PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Feb 27th, 2010
Last updated Feb 27th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104148485 NPPES
Iowa MEDICAID 1982760070

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