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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