Organization
JACQUELINE GUEVARA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE J GUEVARA LCSW (LICENSED CLINICAL SOCIAL WORKER)
(240) 392-1684
Entity
Organization
Contact information
Practice address
601 KING STREET, #260, ALEXANDRIA, VA 22314
(240) 392-1684
Mailing address
8116 ARLINGTON BLVD # 206, FALLS CHURCH, VA 22042-1002
(240) 392-1684
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009490
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326559758
—
VA
Enumeration date
08/20/2018
Last updated
10/05/2022
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