Evergreen Wellness LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

EVERGREEN WELLNESS LLC

Practice address

2583 Gateway Dr Ste 140
State College, PA 16801-3098

Phone

(814) 303-2005

NPI assigned

Aug 17, 2026

Organization subpart

No

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

Authorized official

Name

Jade Moore Stephens, LSW

Title

Owner

Phone

(814) 303-2005

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786924800000",
    "number": "1497660211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2583 GATEWAY DR STE 140",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168013098",
            "telephone_number": "814-303-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2583 GATEWAY DR STE 140",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168013098",
            "telephone_number": "814-303-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "JADE",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-303-2005",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda C. Evans, M.S., L.P.C.
• Christopher R Evans, PHARMD, BCACP
• Joann Evans, CRNP
• John C Evans, D.O.
• Timothy Craig Evans, LPC,CAADAC, MAC, NCC
• Ashley Nicole Evick, CRNA
• Express Medical Supply LLC
• F.Y.Eye, Inc.
• Katherine Anne Fagan
• Dennis Alan Faith, MD

• Social Worker in State College, PA
• Providers in State College, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.