Evergreen Residential Services LLC

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

Legal business name

EVERGREEN RESIDENTIAL SERVICES LLC

Practice address

6405 Dorset Dr
Alexandria, VA 22310-3015

Phone

(240) 601-9977

NPI assigned

Jun 26, 2026

Last updated

Jun 26, 2026By 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

Mary Abosede Dina

Title

Owner

Phone

(240) 601-9977

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1782432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1558287318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 DORSET DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103015",
            "telephone_number": "240-601-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 DORSET DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103015",
            "telephone_number": "240-601-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-26",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "DINA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ABOSEDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-601-9977"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Evanson, FNP
• Takahya Everett- Gatlin
• Deedra Everett, MSW
• Terri Everett, CRNA
• Evergreen Psychiatry, LLC
• Everhart Therapy LLC
• Lindsay Everhart, LCSW
• Leslie M. Evers, RN, C.S.
• Everyday Autism Care LLC
• Everygreen Wave Billing Inc

• Intellectual & Developmental Disabilities Psychologist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Intellectual & Developmental Disabilities Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.