Doctor Name: | MS. ILENE R. EVANTER |
NPI Number: | 1114151826 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.N., B.C.D. |
License Number: | 090400040 |
Business Practice Address: | 6723 Whittier Avenue Suite 405a Mclean, VA - 22101 |
Business Phone Number: | 5712015647 |
Business Fax Number: | |
Mailing Address: | 6723 Whittier Avenue, Suite 405a MCLEAN |
State: | VA |
Postal Code: | 22101 |
Phone Number: | 5712015647 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2009 |
NPI Last Update Date: | 05/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 090400040 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |