Healthcare Provider Details

I. General information

NPI: 1003724568
Provider Name (Legal Business Name): EVERVERA MENTAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 BIG SKY DR
MURPHY NC
28906-3544
US

IV. Provider business mailing address

520 BIG SKY DR
MURPHY NC
28906-3544
US

V. Phone/Fax

Practice location:
  • Phone: 984-367-1172
  • Fax:
Mailing address:
  • Phone: 984-367-1172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MELISSA SLACK
Title or Position: OWNER
Credential: APRN, PMHNP-BC
Phone: 984-367-1172