NPIMap

Organization Active NPI

Evergreen Counseling and Yoga Therapy

  • Mental Health Counselor
  • Vienna, WV
National Provider Identifier
1033814058
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
EVERGREEN COUNSELING AND YOGA THERAPY
Practice address
505 28TH St
Vienna, WV 26105-1451
Phone
(304) 295-4484
NPI assigned
Mar 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nicole Martin, LPCNPI 1356763080
Title
Owner
Phone
(304) 295-4484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

505 28TH St
Vienna, WV 26105-1451

Mailing address

505 28TH St
Vienna, WV 26105-1451
Phone (304) 295-4484

National Provider Directory

National Provider Directory

Locations

505 28th St
Vienna, WV 26105
Phone (304) 295-4484

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1033814058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 28TH ST",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051451",
            "telephone_number": "304-295-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 28TH ST",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051451",
            "telephone_number": "304-295-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN COUNSELING AND YOGA THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-295-4484",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.