Evergreen Counseling Sa, PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

EVERGREEN COUNSELING SA, PLLC

Practice address

11467 Huebner Rd Ste 251
San Antonio, TX 78230-1073

Phone

(503) 389-5504

NPI assigned

Apr 26, 2019

Last updated

Apr 26, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy A Kipp, LFMT-SNPI 1255686812

Title

President

Phone

(503) 389-5504

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

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.

• Amy A Kipp, LMFT

  • Marriage & Family Therapist
  • San Antonio, TX
  • NPI 1255686812
  NPD (past) Authorized official

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556236800000",
    "number": "1063076859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11467 HUEBNER RD STE 251",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301073",
            "telephone_number": "503-389-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11467 HUEBNER RD STE 251",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301073",
            "telephone_number": "503-389-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN COUNSELING SA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-04-26",
        "status": "A",
        "authorized_official_last_name": "KIPP",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-389-5504",
        "authorized_official_credential": "LFMT-S"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12684503",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "amy@amykippcounseling.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Initial contact",
            "address_1": "11467 Huebner Rd Ste 251",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782301073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Everett P. Bratcher M.D.P.a.
• Alexander Timehin Everett
• Amalia M Everett, LPC
• Christopher J. Everett, M.D.
• Gilberto Everett Jr., RPH
• Evergreen Elder Care, Inc.
• Evergreen Hospice & Palliative Care, LLC
• Evergreen Hospice LLC
• Bryan Everitt, M.D.
• Everlasting Home Health Care, Inc.

• Marriage & Family Therapist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.