Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evergreen Assessment & Consultation LLC

Organization Clinical Psychologist · NPI 1467134403

Evergreen Assessment & Consultation LLC is a Clinical Psychologist in Champaign, Illinois. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

411 E Park St Ste 106
Champaign, IL 61820-3862
Phone: (217) 714-7042
Fax: (866) 216-6514
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X

Record details

NPI number1467134403
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jonathan Thomas-Stagg — Owner · (217) 714-7042
NPI enumeratedAugust 1, 2023
Last updated in NPPESAugust 1, 2023
Certification dateAugust 1, 2023
Mailing address411 E Park St Ste 106, Champaign, IL 61820-3862

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