Evergreen Mental Health and Wellness LLC

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

Legal business name

EVERGREEN MENTAL HEALTH AND WELLNESS LLC

Practice address

13168 Mill Stone Dr
Austin, TX 78729-2727

Phone

(512) 591-6841

NPI assigned

Dec 3, 2020

Last updated

Dec 3, 2020By 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

Ms. Rachel Spencer Ivanov, RNNPI 1053916379

Title

President

Phone

(512) 591-6841

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.

• Rachel Spencer Ivanov, MSN, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New Braunfels, TX
  • NPI 1053916379
  NPD (past) Authorized official

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1295330520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13168 MILL STONE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787292727",
            "telephone_number": "512-591-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13168 MILL STONE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787292727",
            "telephone_number": "512-591-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MENTAL HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "IVANOV",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "SPENCER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-591-6841",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Everett
• Charles Earl Everett III, LCSW
• Haley Walker Everett, AGACNP
• Kendra Everette, SLP
• Evergreen Acupuncture
• Everguide Health PLLC
• Mary Nicole Everhart, PA
• Everitt Dental
• Mariah Renee Everitt, LPC-ASSOCIATE
• Everly Provider Group Ca, PC

• Adult Psychiatric/Mental Health Registered Nurse in Austin, TX
• Providers in Austin, TX by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.