EVERGREEN MENTAL HEALTH LLC
NPI 1740715622
Nurse Practitioner - Psychiatric/Mental Health in Liberty Lake, WA
About Evergreen Mental Health Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVERGREEN MENTAL HEALTH LLC (NPI 1740715622) is a healthcare organization registered as a psychiatric/mental health in Liberty Lake, Washington and active in the NPI registry since April 2017. The organization lists Regina Davis, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Evergreen Mental Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Evergreen Mental Health LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Liberty Lake, WA 99019
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Mental Health LLC's NPI number?
The NPI number for Evergreen Mental Health LLC is 1740715622. It was assigned to this organization in the NPPES registry on April 27, 2017.
Where is Evergreen Mental Health LLC located?
Evergreen Mental Health LLC is located at 23403 E Mission Ave Ste 200I, Liberty Lake, WA 99019. The listed phone number is (509) 992-4224.
What is Evergreen Mental Health LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Evergreen Mental Health LLC enrolled in Medicare?
Yes. Evergreen Mental Health LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Evergreen Mental Health LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Evergreen Mental Health LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Evergreen Mental Health LLC accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Evergreen Mental Health LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Evergreen Mental Health LLC was last updated on March 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Evergreen Mental Health Llc · NPI 1740715622
Psychiatric/Mental Health organization in Liberty Lake, Washington. Organization record, active in the CMS NPPES registry since April 27, 2017.
## Identity
- **NPI:** 1740715622 (Entity type: Organization)
- **Enumerated:** April 27, 2017
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Regina Davis, OWNER
## Practice location
- **Address:** 23403 E MISSION AVE STE 200I, Liberty Lake, WA 99019-7575
- **Phone:** (509) 992-4224
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 19, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1740715622) · Data from the CMS NPPES public registry.