EVERGREEN PSYCHOLOGICAL SERVICES, LLC
NPI 1639615206
Psychologist - Clinical in Zionsville, IN

NPI Status: Active since January 06, 2017

Contact Information

1155 PARKWAY DR. STE 200
ZIONSVILLE, IN
ZIP 46077
Phone: (317) 520-4650

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  • Organization
  • Psychologist
  • Clinical

About EVERGREEN PSYCHOLOGICAL SERVICES, LLC

This page provides the complete NPI Profile along with additional information for Evergreen Psychological Services, Llc, a provider established in Zionsville, Indiana operating as a Psychologist, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1639615206 assigned on January 2017. The practitioner's primary taxonomy code is 103TC0700X with license number 20042335A (IN). The provider is registered as an organization and their NPI record was last updated 9 years ago. Evergreen Psychological Services, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mr. Randall A. Young Ma, Lmhc, Licdc, Mac (Vice President/business Administrat)

NPI
1639615206
Provider Name
EVERGREEN PSYCHOLOGICAL SERVICES, LLC
Entity Type
Organization
Location Address
1155 PARKWAY DR. STE 200 ZIONSVILLE, IN 46077
Location Phone
(317) 520-4650
Mailing Address
1155 PARKWAY DR. STE 200 ZIONSVILLE, IN 46077
Mailing Phone
(317) 520-4650
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-06-2017
Last Update Date
04-11-2017
Code Navigator

A clinical psychologist like Evergreen Psychological Services, Llc assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychologist Clinical

Taxonomy Code
103TC0700X
Type
Behavioral Health & Social Service Providers
License No.
20042335A
License State
IN
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1101YM0800XBehavioral Health & Social Service Providers

Counselor
Mental Health

39001948A (IN)

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. RANDALL A. YOUNG MA, LMHC, LICDC, MAC

Authorized Official Title
VICE PRESIDENT/BUSINESS ADMINISTRAT
Authorized Official Phone
(317) 520-4650

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
201002540MEDICAID (05)IN 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1639615206, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
3
Doubled → 6
Pos 4
9
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
1
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
2
Unchanged
Pos 9
0
Doubled → 0
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 6 → 12 → 3 5 → 10 → 1 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 6 + 9 + 1 + 2 + 1 + 1 + 0 + 2 + 0 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1639615206.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639615206, enumerated as an "organization" on January 06, 2017.

The provider is located at 1155 PARKWAY DR. STE 200 ZIONSVILLE, IN 46077 and the phone number is (317) 520-4650.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.