Healthcare Provider Details

I. General information

NPI: 1699639740
Provider Name (Legal Business Name): EVERMORE HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 17TH ST NW UNIT 1603
ATLANTA GA
30363-1087
US

IV. Provider business mailing address

361 17TH ST NW UNIT 1603
ATLANTA GA
30363-1087
US

V. Phone/Fax

Practice location:
  • Phone: 470-945-0787
  • Fax: 470-704-6290
Mailing address:
  • Phone: 470-945-0787
  • Fax: 470-704-6290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TESHA CLEMMONS
Title or Position: CEO/OWNER
Credential:
Phone: 470-945-0787