EVERGREEN PSYCHOLOGICAL SERVICES (NPI# 1104148485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104148485 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PSYCHOLOGICAL SERVICES |
| Practice Address |
313 College Ave Oskaloosa IA 52577-1700 |
| Practice Telephone | 6416700388 |
| Mailing Telephone | 6416700388 |
| Enumeration Date | 2010-02-27 |
| Last Update Date | 2010-02-27 |
| Authorized Official Name | DR. THOMAS POTTER (PSYCHOLOGIST) |
| Authorized Official Telephone | 6416700388 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1982760070 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVERGREEN PSYCHOLOGICAL SERVICES, LLC | 2616 Placid Ave Nw, Olympia, WA 98502-3007 |
| Oregon Corporations, Companies and Business Names | EVERGREEN PSYCHOLOGICAL SERVICES, LLC | 663 Cottage Street Ne, Salem, OR 97301 |
| Street Address |
313 COLLEGE AVE |
| City | OSKALOOSA |
| State | IA |
| Zip Code | 52577-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245870781 | Arthur Zacharjasz | Nurse Practitioner | 1229 C Ave E, Oskaloosa, Ia 52577, Oskaloosa, IA 52577 | 2020-01-13 |
| 1306373089 | Kristal Williams | Counselor | 114 N. Market St., Oskaloosa, IA 52577 | 2017-05-12 |
| 1801345830 | Kristi Lyn Foster | Hearing Instrument Specialist | 714 A Ave West, Oskaloosa, IA 52577 | 2016-10-03 |
| 1972811198 | Crossroads of Pella | Community/Behavioral Health | 103 North 3rd Street, Oskaloosa, IA 52577 | 2010-09-22 |
| 1184809477 | Carli Raye Hahn | Psychologist | 814 2nd Ave East, Oskaloosa, IA 52577 | 2008-01-04 |
| 1982824173 | Laura Adam | Dentist | 2335 Hwy 92 E, Oskaloosa, IA 52577 | 2007-04-27 |
| 1891910881 | Homestead of Oskaloosa Operations LLC | Assisted Living Facility | 2102 South Market Street, Oskaloosa, IA 52577 | 2007-04-16 |
| 1194891374 | Karen Anne Spahr | Internal Medicine | 1203 A Ave East, Oskaloosa, IA 52577 | 2006-11-28 |
| 1376626648 | Wal-mart Stores, Inc. | Technician/Technologist | 2203 Avenue A West, Oskaloosa, IA 52577 | 2006-10-23 |
| 1003913229 | Heartland Home Care Inc | Home Health | 212 North Market Street, Oskaloosa, IA 52577 | 2006-09-20 |
| Find all providers in zip 52577 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952966533 | Bridges Community Services, LLC | Psychologist | 110 Nw 2nd St, Stuart, IA 50250 | 2019-05-08 |
| 1659873727 | Willow Grove Therapy Group LLC | Psychologist | 5000 Westown Pkwy Ste 100, West Des Moines, IA 50266-5921 | 2018-03-05 |
| 1295248326 | Kristen Nicole Sievert | Psychologist | 4720 Mortensen Rd Ste 104, Ames, IA 50014-5534 | 2017-11-11 |
| 1609320902 | Summer K. Brunscheen, LLC | Psychologist | 2515 University Blvd Ste 102, Ames, IA 50010-8628 | 2016-08-04 |
| 1235513011 | Sheila Pogge | Psychologist | 520 10th Ave Lowr Level, Coralville, IA 52241-1910 | 2015-07-12 |
| 1861814428 | Nathaniel Wade | Psychologist | 2613 Northridge Pkwy, Suite 105, Ames, IA 50010-4096 | 2014-01-15 |
| 1023367018 | Michelle Leigh Cushman | Psychologist | 431 28th St Ste 204, Des Moines, IA 50312-4400 | 2012-09-05 |
| 1548563901 | Davis Psychological Services, PC | Psychologist | 821 5th Ave, Suite 201, Grinnell, IA 50112-1653 | 2010-12-07 |
| 1598988024 | Eugene R Deisinger | Psychologist | 2521 Elwood Dr Ste 121, Ames, IA 50010-8229 | 2007-04-11 |
| 1992822670 | Lanaya Lynn Ethington | Psychologist | 720 S Dubuque St Ste 1, Iowa City, IA 52240-4242 | 2007-03-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.