Provider Demographics
NPI:1841435286
Name:FOR CHILDREN'S SAKE OF VIRGINIA
Entity type:Organization
Organization Name:FOR CHILDREN'S SAKE OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-817-9890
Mailing Address - Street 1:14900 BOGLE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1756
Mailing Address - Country:US
Mailing Address - Phone:703-817-9890
Mailing Address - Fax:571-321-0322
Practice Address - Street 1:14900 BOGLE DR
Practice Address - Street 2:STE 200
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1756
Practice Address - Country:US
Practice Address - Phone:703-817-9890
Practice Address - Fax:571-321-0322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health