Evergreen Clinical Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EVERGREEN CLINICAL SERVICES LLC

Practice address

444 Manhattan Ave Apt 6K
New York, NY 10026-1068

Phone

(917) 868-6745

NPI assigned

Nov 15, 2024

Last updated

Dec 2, 2024By 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

Boris Ingberg, LCSWNPI 1720392251

Title

Owner

Phone

(917) 868-6745

Specialties & licenses 1

Addresses

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.

• Boris Ingberg, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1720392251
  Authorized official Same address or phone

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1073338067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MANHATTAN AVE APT 6K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261068",
            "telephone_number": "917-868-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 MANHATTAN AVE APT 6K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261068",
            "telephone_number": "917-868-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN CLINICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "INGBERG",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-868-6745",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darcie Lyn Everett, MD, MPH
• Kenrick Everett, DPP COACH
• Marc Everett, MD
• Shaqwanda Everett
• Evergreen Choice LLC
• Evergreen Global Solutions
• Evergreen Medical Clinic P.C
• Evergreen Therapeutic Collective LLC
• Evergreen Therapeutic Practice LCSW PLLC
• Evergreen Wellness Health LLC (Betty Wang MD)

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.