# EVERGREEN THERAPEUTIC, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346840873
- **Authorized official:** ANNA BENGTSON BROADWELL MA, MDIV, LCMHC (THERAPIST)
- **Authorized official phone:** (919) 561-9663

## Contact information

- **Practice address:** 7427 OLD STAGE RD N, ANGIER, NC 27501-7401
- **Practice address phone:** (919) 561-9663
- **Mailing address:** PO BOX 37501, RALEIGH, NC 27627-7501
- **Mailing address phone:** (919) 249-8675

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 10/26/2020
- **Last updated:** 10/26/2020