Organization
AVESTA MENTAL HEALTH
Active
Organization
AVESTA MENTAL HEALTH
Active
Other names
Avesta Ketamine and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LADAN ESHKEVARI PHD, CRNA (CEO)
(703) 201-7767
Entity
Organization
Contact information
Practice address
4833 RUGBY AVE STE 400, BETHESDA, MD 20814-3915
(301) 778-1022
Mailing address
1268 BEVERLY RD, MC LEAN, VA 22101-2834
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
261Q00000X
Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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