=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003724568
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EVERVERA MENTAL HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2026
-----------------------------------------------------
Last Update Date | 08/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 520 BIG SKY DR
-----------------------------------------------------
City | MURPHY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28906-3544
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 984-367-1172
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 520 BIG SKY DR
-----------------------------------------------------
City | MURPHY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28906-3544
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 984-367-1172
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MELISSA SLACK
-----------------------------------------------------
Credential | APRN, PMHNP-BC
-----------------------------------------------------
Telephone | 984-367-1172
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------