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Organization

EVERGREEN THERAPY SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA MARIE NELSON LISW (MENTAL HEALTH THERAPIST)
(515) 619-6855
Entity
Organization

Contact information

Practice address
1605 N ANKENY BLVD STE 110, ANKENY, IA 50023-4163
(515) 619-6855
Mailing address
1605 N ANKENY BLVD STE 110, ANKENY, IA 50023-4163
(515) 619-6855

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107268
IOWA DEPT. OF PUBLIC HEALTH / BOARD OF SOCIAL WORK
IA
Enumeration date
02/12/2025
Last updated
02/12/2025
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