Provider Demographics
NPI:1619489424
Name:EVERWHEN THERAPY, LLC
Entity Type:Organization
Organization Name:EVERWHEN THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MA-ATR, LPC
Authorized Official - Phone:571-234-9184
Mailing Address - Street 1:3950 CHAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3935
Mailing Address - Country:US
Mailing Address - Phone:571-234-9184
Mailing Address - Fax:703-277-9898
Practice Address - Street 1:3950 CHAIN BRIDGE RD STE 10
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3935
Practice Address - Country:US
Practice Address - Phone:571-234-9184
Practice Address - Fax:703-277-9898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005276101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701005276OtherLICENSE