Organization
EVERGREEN WELLNESS CENTER, LLC
Active
Organization
EVERGREEN WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA NILI UTH PSYD (MANAGER)
(508) 386-2094
Entity
Organization
Contact information
Practice address
171 HIGHLAND ST APT 303, TAUNTON, MA 02780-4446
(508) 386-2094
(508) 967-7194
Mailing address
PO BOX 767, WEST WARWICK, RI 02893-0610
(508) 386-2094
(508) 967-7194
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110165840A
—
MA
Enumeration date
08/11/2020
Last updated
05/24/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up