Evergrow Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EVERGROW COUNSELING LLC

Practice address

843 Main St Ste 2
Manchester, CT 06040-6041

Phone

(203) 927-6409

NPI assigned

Oct 8, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Jaleesa M Hernandez, LPC, NCC

Title

Behavioral Health Clinician

Phone

(203) 927-6409

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jaleesa Hernandez Jones, M.S., LPC

  • Professional Counselor
  • Manchester, CT
  • NPI 1891038956
  NPD

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1487129284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 MAIN ST STE 2",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406041",
            "telephone_number": "203-927-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 MAIN ST STE 2",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406041",
            "telephone_number": "203-927-6409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "843 Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060406054",
            "country_code": "US",
            "telephone_number": "203-927-6409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVERGROW COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JALEESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH CLINICIAN",
        "authorized_official_telephone_number": "203-927-6409",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891038956",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Manchester, CT
• Providers in Manchester, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.