Provider Demographics
NPI:1689116451
Name:DEVALERA, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DEVALERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 RITTENHOUSE ST NW
Mailing Address - Street 2:UNIT F
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1153
Mailing Address - Country:US
Mailing Address - Phone:202-210-1299
Mailing Address - Fax:
Practice Address - Street 1:3845 S CAPITOL ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-1419
Practice Address - Country:US
Practice Address - Phone:202-563-1391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCACII1254101YA0400X
DCPRC14847101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)