Healthcare Provider Details
I. General information
NPI: 1548198724
Provider Name (Legal Business Name): EVERLASTING HILLS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
311 S EDDY ST
SOUTH BEND IN
46617-3201
US
IV. Provider business mailing address
311 S EDDY ST
SOUTH BEND IN
46617-3201
US
V. Phone/Fax
- Phone: 574-213-2456
- Fax:
- Phone: 574-213-2456
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ZACHARY
LEE
KYLE
Title or Position: OWNER
Credential: MSW, LCSW
Phone: 574-213-2456