Healthcare Provider Details

I. General information

NPI: 1669394094
Provider Name (Legal Business Name): EVERLOOM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5799 THE SQ
CROZET VA
22932-3182
US

IV. Provider business mailing address

PO BOX 177
CROZET VA
22932-0177
US

V. Phone/Fax

Practice location:
  • Phone: 434-205-1769
  • Fax:
Mailing address:
  • Phone: 434-205-1769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MS. RAMONA MARTIN
Title or Position: FOUNDER, DIRECTOR
Credential: SPECIAL EDUCATOR
Phone: 434-205-1769