Evergreen Therapy Group, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EVERGREEN THERAPY GROUP, LLC

Practice address

11 Byte CT Ste C
Frederick, MD 21702-8718

Phone

(240) 478-8092

NPI assigned

Dec 22, 2023

Last updated

Dec 22, 2023By 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

Michelle Rizk Bavender, LCSW-C

Title

Owner and Psychotherapist

Phone

(240) 478-8092

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michelle Rizk

  • Social Worker
  • Frederick, MD
  • NPI 1184197212
  NPD

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1942079553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20156 CAMELLIA CROSSE LN",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339284062",
            "telephone_number": "240-478-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BYTE CT STE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217028718",
            "telephone_number": "240-478-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN THERAPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-22",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "BAVENDER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "RIZK",
        "authorized_official_title_or_position": "OWNER AND PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "240-478-8092",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Evans, LMT
• Patrick John Evans, MHA, LAT, ATC
• Ever-Will Healthcare Services (ever-will)
• Evercare Health Services, Inc.
• Evergreen Psychology, LLC
• Lindsay Ewald
• Aaron Exum, LMT
• Eye to Eye of Frederick Inc
• Gail Eye
• Melissa Eyler, RMP

• Clinical Social Worker in Frederick, MD
• Providers in Frederick, MD by specialty
• Clinical Social Worker in Maryland

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