Evergreen Educational Therapy LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

EVERGREEN EDUCATIONAL THERAPY LLC

Practice address

709 E Colorado Blvd Ste 250
Pasadena, CA 91101-2159

Phone

(626) 214-8972

Fax

(626) 517-5083

NPI assigned

Aug 19, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Amanda Lepore, ET/PNPI 1427760388

Title

Executive Director

Phone

(626) 977-4211

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.

• Amanda Lepore, ET/P

  • Counselor
  • Pasadena, CA
  • NPI 1427760388
  NPD Authorized official

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1972335784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 E COLORADO BLVD STE 250",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012159",
            "telephone_number": "626-214-8972",
            "fax_number": "626-517-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 E COLORADO BLVD STE 250",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012159",
            "telephone_number": "626-214-8972",
            "fax_number": "626-517-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN EDUCATIONAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "LEPORE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-977-4211",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ET/P"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.