Evergreen Psychological Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

04688 Issued in MD

Legal business name

EVERGREEN PSYCHOLOGICAL SERVICES LLC

Practice address

5724 Falls Rd
Baltimore, MD 21209-3708

Phone

(410) 336-5329

Fax

(410) 878-2783

NPI assigned

Feb 4, 2009

Last updated

Feb 19, 2023By 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

Dr. Paul Patrick Giggey, PH.D.NPI 1629272711

Title

Director

Phone

(410) 336-5329

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

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.

• Paul Patrick Giggey, PH.D.

  • Psychologist
  • Baltimore, MD
  • NPI 1629272711
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676764800000",
    "number": "1164661799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16277",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212100277",
            "telephone_number": "410-336-5329",
            "fax_number": "410-878-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5724 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093708",
            "telephone_number": "410-336-5329",
            "fax_number": "410-878-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2023-02-19",
        "certification_date": "2023-02-19",
        "status": "A",
        "authorized_official_last_name": "GIGGEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-336-5329",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "04688",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Miles Everett, M.D.
• Tanisha Everett, LCSW-C
• Evergreen Healthcare Clinic Limited Liability Company
• Evergreen Healthcare Clinic Limited Liability Company
• Evergreen Mental Health Services, Inc.
• Janice Talia Everheart
• Ian Kyle Everitt, MD
• Everlasting Arms Health Services
• Everlasting Arms Inc.
• Everlasting Arms Inc.

• Clinical Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2023; 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.