Organization
EVERGREEN THERAPY SERVICES, LLC
Active
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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