Provider Demographics
NPI:1053022285
Name:EVERGREEN HOPE COUNSELING, PLLC
Entity type:Organization
Organization Name:EVERGREEN HOPE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:KATHRYN-WEST
Authorized Official - Last Name:DEBONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-246-1465
Mailing Address - Street 1:1176 S MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2252
Mailing Address - Country:US
Mailing Address - Phone:920-246-1465
Mailing Address - Fax:
Practice Address - Street 1:1176 S MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2252
Practice Address - Country:US
Practice Address - Phone:920-246-1465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty