Healthcare Provider Details

I. General information

NPI: 1215727383
Provider Name (Legal Business Name): EVERGREEN COUNSELING AND CONSULTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2025
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 S MINNESOTA AVE STE 102
SIOUX FALLS SD
57108-2570
US

IV. Provider business mailing address

6809 S MINNESOTA AVE STE 102
SIOUX FALLS SD
57108-2570
US

V. Phone/Fax

Practice location:
  • Phone: 605-423-7880
  • Fax: 605-972-1904
Mailing address:
  • Phone: 605-423-7880
  • Fax: 605-972-1904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PAIGE ELIZABETH THOMPSON
Title or Position: OWNER
Credential:
Phone: 605-423-7880