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

Q: What is Evergreen Psychological Services, LLC's specialty?

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

Active since January 06, 2017

1155 PARKWAY DR. STE 200, ZIONSVILLE, IN 46077(317) 520-4650 Get Directions Write a Review

NPPES record last updated: April 11, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 11, 2017, Jan 6, 2017 (2 updates tracked since 2017).

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About Evergreen Psychological Services, Llc NPPES

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

EVERGREEN PSYCHOLOGICAL SERVICES, LLC (NPI 1639615206) is a healthcare organization registered as a clinical in Zionsville, Indiana and active in the NPI registry since January 2017. The organization lists Randall A. Young, Vice President/business Administrat, as its authorized official.

NPPES Registry Identity

NPI1639615206

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameEVERGREEN PSYCHOLOGICAL SERVICES, LLC

Location Address1155 PARKWAY DR. STE 200Zionsville, IN 46077-8541

Mailing Address1155 Parkway Dr. Ste 200Zionsville, IN 46077-8541 · (317) 520-4650

Phone(317) 520-4650

Organization SubpartNo

Authorized OfficialRandall A. YoungVice President/business Administrat · (317) 520-4650

Enumeration DateJanuary 6, 2017

Last NPPES UpdateApril 11, 20172 updates tracked since enumeration

✔ NPI 1639615206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IN · 20042335A

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.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 39001948A (IN)

1155 PARKWAY DR. STE 200, Zionsville, IN 46077

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Other Identifiers 1

Medicaid201002540IN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Psychological Services, LLC's NPI number?

The NPI number for Evergreen Psychological Services, LLC is 1639615206. It was assigned to this organization in the NPPES registry on January 6, 2017.

Where is Evergreen Psychological Services, LLC located?

Evergreen Psychological Services, LLC is located at 1155 Parkway Dr. Ste 200, Zionsville, IN 46077. The listed phone number is (317) 520-4650.

What is Evergreen Psychological Services, 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 Psychological Services, LLC was last updated on April 11, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.