MEDICARE: EVERMORE HEALTH & WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
5	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1699639740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERMORE HEALTH & WELLNESS

Provider Business Mailing Address
First Line	:	361 17TH ST NW UNIT 1603
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30363-1087
Country	:	US
Telephone Number	:	470-945-0787
Fax Number	:	470-704-6290

Provider Business Practice Location Address
First Line	:	361 17TH ST NW UNIT 1603
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30363-1087
Country	:	US
Telephone Number	:	470-945-0787
Fax Number	:	470-704-6290

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	TESHA CLEMMONS
Credential	:
Telephone Number	:	470-945-0787

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “EVERMORE HEALTH & WELLNESS ” Practice Location

Language	Start Address	Practice Location

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