Healthcare Provider Details

I. General information

NPI: 1639083009
Provider Name (Legal Business Name): EVERWELL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 N ROCK RD STE 131
DERBY KS
67037-3681
US

IV. Provider business mailing address

620 N ROCK RD STE 131
DERBY KS
67037-3681
US

V. Phone/Fax

Practice location:
  • Phone: 316-200-8971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: EMILY STUART
Title or Position: OWNER
Credential: LSCSW
Phone: 316-200-8971