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EVERGREEN ASSESSMENT & CONSULTATION LLC
NPI 1467134403
Psychologist - Clinical in Champaign, IL

Active since August 01, 2023
411 E PARK ST STE 106, CHAMPAIGN, IL 61820(217) 714-7042(866) 216-6514 Get Directions Write a Review

NPPES record last updated: August 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Evergreen Assessment & Consultation Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN ASSESSMENT & CONSULTATION LLC (NPI 1467134403) is a healthcare organization registered as a clinical in Champaign, Illinois and active in the NPI registry since August 2023. The organization lists Jonathan William Thomas-stagg, Owner, as its authorized official.

NPPES Registry Identity

NPI1467134403
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameEVERGREEN ASSESSMENT & CONSULTATION LLC
Location Address411 E PARK ST STE 106Champaign, IL 61820-3862
Mailing Address411 E Park St Ste 106Champaign, IL 61820-3862 · (217) 714-7042 · Fax (866) 216-6514
Phone(217) 714-7042
Fax(866) 216-6514
Organization SubpartNo
Authorized OfficialJonathan William Thomas-staggOwner · (217) 714-7042
Enumeration DateAugust 1, 2023
NPPES CertifiedAugust 1, 2023
✔ NPI 1467134403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
411 E PARK ST STE 106, Champaign, IL 61820
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISYN WELSH
Social Worker
411 E PARK ST STE 106
CHAMPAIGN, IL 61820
Champaign County (217) 714-7042
SALMAN AHMAD SAFIR MA
Counselor
411 E PARK ST STE 106
CHAMPAIGN, IL 61820
Champaign County (217) 714-7042
MS. AMANDA P GOLD
Counselor (Mental Health)
411 E PARK ST STE 106
CHAMPAIGN, IL 61820
Champaign County (217) 714-7042
MS. RACHEL JACKSON GREEN MSW, LSW
Social Worker
411 E PARK ST STE 106
CHAMPAIGN, IL 61820
Champaign County (217) 714-7042
TAYLOR J COX
Counselor
411 E PARK ST STE 106
CHAMPAIGN, IL 61820
Champaign County (217) 714-7042
CHELSEA LAMB LCSW
Social Worker (Clinical)
411 E PARK ST STE 106
CHAMPAIGN, IL 61820
Champaign County (217) 714-7042
BRITTNEY HOMANN MSW, LCSW
Social Worker (Clinical)
411 E PARK ST STE 106
CHAMPAIGN, IL 61820
Champaign County (217) 714-7042
EVERGREEN COACHING AND COUNSELING, INC.
Clinic/Center (Adult Mental Health)
411 E PARK ST STE 106
CHAMPAIGN, IL 61820
Champaign County (217) 714-7042

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Assessment & Consultation LLC's NPI number?

The NPI number for Evergreen Assessment & Consultation LLC is 1467134403. It was assigned to this organization in the NPPES registry on August 1, 2023.

Where is Evergreen Assessment & Consultation LLC located?

Evergreen Assessment & Consultation LLC is located at 411 E Park St Ste 106, Champaign, IL 61820. The listed phone number is (217) 714-7042.

What is Evergreen Assessment & Consultation LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Evergreen Assessment & Consultation LLC was last updated on August 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.