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General NPI Number Information
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NPI Number | 1033069422
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Entity Type | Organization
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Legal Business Name | DEEPLY ROOTED MENTAL HEALTH COUNSEL ING PLLC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 418 BROADWAY STE R
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City | ALBANY
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State | NY
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Zip | 12207-2922
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Country | US
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Telephone | 516-486-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 208 STEEPLE CT
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City | PERRY
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State | GA
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Zip | 31069-4595
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Country | US
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Telephone | 347-494-2760
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YONETTE NICOLE MATILDE EVERSLEY
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Credential | LMHC
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Telephone | 516-486-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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