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Organization

FOR CHILDREN'S SAKE OF VIRGINIA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH K EVANS LCSW, BCD (CEO)
(703) 817-9890
Entity
Organization

Contact information

Practice address
14900 BOGLE DR, SUITE 200, CHANTILLY, VA 20151-1756
(703) 817-9890
(703) 817-9860
Mailing address
14900 BOGLE DR, SUITE 200, CHANTILLY, VA 20151-1756
(703) 817-9890
(703) 817-9860

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0904008453
VA
1041C0700X
Clinical Social Worker
Primary
0904003512
VA
1041C0700X
Clinical Social Worker
0904006815
VA
1041C0700X
Clinical Social Worker
0904007372
VA
1041C0700X
Clinical Social Worker
904002080
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1639281231
VA
Enumeration date
08/31/2006
Last updated
05/23/2014
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