Provider Demographics
NPI:1912449927
Name:EVERHART, DANIELLE (LBA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:EVERHART
Suffix:
Gender:F
Credentials:LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 HARRISON ST SE STE 1A
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3729
Mailing Address - Country:US
Mailing Address - Phone:703-496-7804
Mailing Address - Fax:571-359-6784
Practice Address - Street 1:305 HARRISON ST SE STE 1A
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3729
Practice Address - Country:US
Practice Address - Phone:703-496-7804
Practice Address - Fax:571-359-6784
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000539103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst