Provider Demographics
NPI:1386849578
Name:EVANS, DAVID STEWART (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:STEWART
Last Name:EVANS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8308 OLD COURTHOUSE RD
Mailing Address - Street 2:SUITE
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3863
Mailing Address - Country:US
Mailing Address - Phone:703-734-3514
Mailing Address - Fax:
Practice Address - Street 1:8308 OLD COURTHOUSE RD
Practice Address - Street 2:SUITE B
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3863
Practice Address - Country:US
Practice Address - Phone:703-734-3514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040014821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical