Provider Demographics
NPI:1497341523
Name:EVERHART THERAPY LLC
Entity type:Organization
Organization Name:EVERHART THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:EVERHART
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:571-360-4083
Mailing Address - Street 1:107 S WEST ST STE 578
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2824
Mailing Address - Country:US
Mailing Address - Phone:571-402-5410
Mailing Address - Fax:
Practice Address - Street 1:324 N FAIRFAX ST STE 200
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2625
Practice Address - Country:US
Practice Address - Phone:571-360-4083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-13
Last Update Date:2021-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty