NPIMap

Organization Active NPI

Evergreen Counseling and Psychological Associates LLC

  • Professional Counselor
  • Philadelphia, PA
National Provider Identifier
1053748939
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
EVERGREEN COUNSELING AND PSYCHOLOGICAL ASSOCIATES LLC
Practice address
8705 Germantown Ave Ste 3
Philadelphia, PA 19118-2720
Phone
(215) 247-5400
NPI assigned
Oct 8, 2013
Last updated
Jun 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Dr. Christine McGuire, PSY.D.NPI 1225130149
Title
Clinical Director
Phone
(215) 247-5400

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PS016945 PA
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

8705 Germantown Ave Ste 3
Philadelphia, PA 19118-2720

Mailing address

8705 Germantown Ave Ste 3
Philadelphia, PA 19118-2720
Phone (215) 247-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140812002138 PA Part B Supplier - Clinic/Group Practice 3577780782 Receives reassigned benefits from 10 practitioners
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

18 Elizabeth St
Conshohocken, PA 19428
Phone (215) 247-5400

7600 Stenton Ave
Ste 1F
Philadelphia, PA 19118
Phone (215) 247-5400

8705 Germantown Ave
Ste 3
Philadelphia, PA 19118
Phone (215) 247-5400

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1381190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1053748939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8705 GERMANTOWN AVE STE 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182720",
            "telephone_number": "215-247-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8705 GERMANTOWN AVE STE 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182720",
            "telephone_number": "215-247-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN COUNSELING AND PSYCHOLOGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-08",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "MCGUIRE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "215-247-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016945",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.