Evergreen Therapy PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

EVERGREEN THERAPY PLLC

Doing business as

Erin Rayburn DBA Evergreen Therapy PLLC

Practice address

748 Overbridge LN Ste 12
Chattanooga, TN 37405-3320

Phone

(423) 364-9955

NPI assigned

Sep 2, 2022

Organization subpart

No

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

Authorized official

Name

Erin Rayburn, LMFT, LPC-MHSP, NCCNPI 1063872257

Title

Owner

Phone

(423) 364-9955

Specialties & licenses 3

Addresses

Other names 1

• Erin Rayburn DBA Evergreen Therapy PLLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erin Rayburn, LMFT, LPC-MHSP, NCC

  • Marriage & Family Therapist
  • Chattanooga, TN
  • NPI 1063872257

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1396465894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 311",
            "city": "LOOKOUT MOUNTAIN",
            "state": "TN",
            "postal_code": "373500311",
            "telephone_number": "423-364-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 OVERBRIDGE LN STE 12",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374053320",
            "telephone_number": "423-364-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "RAYBURN",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-364-9955",
        "authorized_official_credential": "LMFT, LPC-MHSP, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Erin Rayburn DBA Evergreen Therapy PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marriage & Family Therapist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Marriage & Family Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.