Organization Active NPI

Evergreen Counseling SVS.,

  • Mental Health Counselor
  • Bedford, NH
National Provider Identifier
1700087509
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11 Issued in NH
Legal business name
EVERGREEN COUNSELING SVS.,
Practice address
82 Palomino LN
Suite 702
Bedford, NH 03110-6448
Phone
(603) 626-5400
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Donna GuldensternNPI 1477685402
Title
President
Phone
(603) 626-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 11 NH Primary

Addresses

Primary practice location

82 Palomino LN
Suite 702
Bedford, NH 03110-6448

Mailing address

82 Palomino LN
Suite 702
Bedford, NH 03110-6448
Phone (603) 626-5400

Other identifiers 1

IdentifierTypeStateIssuer
30007116MedicaidNH

National Provider Directory

National Provider Directory

Locations

82 Palomino Ln
Ste 702
Bedford, NH 03110
Phone (603) 626-5400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700087509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 PALOMINO LN",
            "address_2": "SUITE 702",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106448",
            "telephone_number": "603-626-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 PALOMINO LN",
            "address_2": "SUITE 702",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106448",
            "telephone_number": "603-626-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN COUNSELING SVS.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GULDENSTERN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-626-5400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "11",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30007116",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.