# EVERGREEN THERAPY SERVICES-LLC

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

## Provider details

- **NPI number:** 1720656135
- **Authorized official:** PAMELA M MIDDLETON LSCSW (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (785) 483-9183

## Contact information

- **Practice address:** 1819 11TH ST, GREAT BEND, KS 67530-4511
- **Practice address phone:** (785) 483-9183
- **Mailing address:** 1819 11TH ST, GREAT BEND, KS 67530-4511
- **Mailing address phone:** (785) 483-9183

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2021
- **Last updated:** 08/03/2021