Provider Demographics
NPI:1366675647
Name:EVANS, LYNDA PHILLIPS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:PHILLIPS
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8911 SIERRA RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-7828
Mailing Address - Country:US
Mailing Address - Phone:804-543-0541
Mailing Address - Fax:804-264-1029
Practice Address - Street 1:5821 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-5427
Practice Address - Country:US
Practice Address - Phone:804-264-0966
Practice Address - Fax:804-264-1012
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002530101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701002530OtherBOARD OF HEALTH PROFESSIONALS