NPI Code Details Logo

NPI 1477264190

NPI 1477264190 : EVERMORE THERAPY AND WELLNESS GROUP LLC : BROWNSBURG, IN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1477264190
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    EVERMORE THERAPY AND WELLNESS GROUP LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/13/2022
-----------------------------------------------------
    Last Update Date     |    05/15/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    660 PATRICK PL 
-----------------------------------------------------
    City                 |    BROWNSBURG
-----------------------------------------------------
    State                |    IN
-----------------------------------------------------
    Zip                  |    46112-2110
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    317-619-8964
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1730 CARDINAL LN 
-----------------------------------------------------
    City                 |    BROWNSBURG
-----------------------------------------------------
    State                |    IN
-----------------------------------------------------
    Zip                  |    46112-8863
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    317-619-8964
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |     MEGAN  ELDREDGE 
-----------------------------------------------------
    Credential           |    LCSW
-----------------------------------------------------
    Telephone            |    317-619-8964
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YM0800X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Counselor
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.