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General NPI Number Information
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NPI Number | 1326690777
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Entity Type | Organization
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Legal Business Name | EVERLY COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 07/15/2019
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 4601 50TH ST STE 201
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City | LUBBOCK
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State | TX
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Zip | 79414-3518
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Country | US
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Telephone | 806-445-3763
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Fax |
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Provider Business Mailing Address
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Address Line | 6401 COUNTY ROAD 1470
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City | LUBBOCK
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State | TX
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Zip | 79407-5804
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Country | US
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Telephone | 806-445-3763
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEIGH GREEN
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Credential |
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Telephone | 806-445-3763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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