Evergreen Counseling Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EVERGREEN COUNSELING SERVICES LLC

Practice address

4318 Old Hundred Rd Ste C
Chester, VA 23831-4231

Phone

(804) 621-5572

Fax

(804) 821-1253

NPI assigned

Mar 2, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Cristal R Jenkins, LCSW

Title

Owner

Phone

(804) 621-5572

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1629725478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 SUNSET AVE",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238316616",
            "telephone_number": "804-821-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 OLD HUNDRED RD STE C",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238314231",
            "telephone_number": "804-621-5572",
            "fax_number": "804-821-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "CRISTAL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-621-5572",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RESILIENTEVERGREEN.COM",
            "affiliation": "N",
            "endpointDescription": "EVERGREEN COUNSELING SERVICES",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4318 Old Hundred Rd Ste C",
            "city": "Chester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "238314231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Chester, VA
• Providers in Chester, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.