Healthcare Provider Details

I. General information

NPI: 1841085388
Provider Name (Legal Business Name): EVERGREEN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 NORTH FRONT ST.
BURBANK OH
44214
US

IV. Provider business mailing address

14744 FRANCHESTER RD
WEST SALEM OH
44287-9511
US

V. Phone/Fax

Practice location:
  • Phone: 330-887-2231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: ALLISON WOLFERD
Title or Position: OWNER/CLINICIAN
Credential: MSW, LISW-S
Phone: 216-970-5207