Provider Demographics
NPI:1225626880
Name:EVERHART, CHANDA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CHANDA
Middle Name:
Last Name:EVERHART
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15901 SHARPERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3704
Mailing Address - Country:US
Mailing Address - Phone:240-532-2195
Mailing Address - Fax:
Practice Address - Street 1:15901 SHARPERSVILLE RD
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3704
Practice Address - Country:US
Practice Address - Phone:240-532-2195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000014881041C0700X
MD237581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty