Yonette Nicole Matilde Eversley
Individual provider Active NPI Mental Health Counselor · Perry, GA
NPI 1497580047 · NPPES record last updated Sep 6, 2024
Key facts
- NPI
- 1497580047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 18-P123904-01 (NY)
- Practice address
- 208 Steeple CT
Perry, GA 31069-4595 - Phone
- (347) 494-2760
- NPI assigned
- Sep 4, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251209002261 | NY | Practitioner - Mental Health Counselor | 9638663560 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-P123904-01 | NY | MD | Mental Health Counselor |
| 016547 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deeply Rooted Mental Health Counsel Ing PLLC | Current |
Accepting new patients | |
| Grow Healthcare Group PA | Mental Health | Current |
Accepting new patients |
| Resilience Psychotherapy LCSW PC | Past | Accepting new patients |
Locations
165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 18-P123904-01 | NY | Yes |
Addresses
Primary practice location
208 Steeple CT
Perry, GA 31069-4595
Mailing address
208 Steeple CT
Perry, GA 31069-4595
Phone (347) 494-2760
Other providers in Perry, GA
- Christina Woodall Easler
- Emory Physical Therapy, LLC
- Encouragement Counseling, LLC
- Otha Everett
- Ebony Everette
- David Lee Faircloth
- Samantha B Faircloth
- Carson Farrell Fay
- Logan Daryl Felker
- Felts Training Institute
All providers in Perry, GA · Mental Health Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.