OrganizationActive
Evergreen Assessment & Consultation LLC
NPI 1467134403 · Clinical Psychologist · Champaign, IL
Provider details
- NPI number
- 1467134403
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Jonathan Thomas-Stagg, Owner(217) 714-7042
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
411 E Park St Ste 106
Champaign, IL 61820-3862
Phone: (217) 714-7042
Fax: (866) 216-6514
Street-level locationGet directions
Mailing address
411 E Park St Ste 106
Champaign, IL 61820-3862
Registry dates
- Enumerated
- 2023-08-01
- Last updated
- 2023-08-01
- Certified
- 2023-08-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.