{"npi":"1467134403","type":"NPI-2","status":"active","name":{"display":"Evergreen Assessment & Consultation LLC","other":[],"organization_name":"EVERGREEN ASSESSMENT & CONSULTATION LLC","authorised_official":"Jonathan Thomas-Stagg"},"specialty":{"primary_taxonomy":"103TC0700X","primary_taxonomy_description":"Clinical Psychologist","slug":"clinical-psychologist","schema_org_specialty":null,"all":[{"code":"103TC0700X","description":"Clinical Psychologist","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"411 E PARK ST STE 106","city":"CHAMPAIGN","state":"IL","postal_code":"618203862","country_code":"US","phone":"2177147042","fax":"8662166514"},{"purpose":"MAILING","street_1":"411 E PARK ST STE 106","city":"CHAMPAIGN","state":"IL","postal_code":"618203862","country_code":"US","phone":"2177147042","fax":"8662166514"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2023-08-01","last_updated":"2023-08-01","_meta":{"source":"NPPES","snapshot_date":"2023-08-01","doc_url":"https://findmynpi.com/api"}}