Provider Demographics
NPI:1639330764
Name:CHEN, EVA (LCSW-C, CEAP, CRC)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:LCSW-C, CEAP, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13873 GREY COLT DR
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3869
Mailing Address - Country:US
Mailing Address - Phone:301-412-7943
Mailing Address - Fax:
Practice Address - Street 1:15841 CRABBS BRANCH WAY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-6625
Practice Address - Country:US
Practice Address - Phone:301-412-7943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD120681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical