Provider Demographics
NPI:1376863076
Name:EVANS, LINDA BLUE (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:BLUE
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 1:4012 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6108
Mailing Address - Country:US
Mailing Address - Phone:919-673-2346
Mailing Address - Fax:919-661-6287
Practice Address - Street 1:4012 PEARL RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-6108
Practice Address - Country:US
Practice Address - Phone:919-673-2346
Practice Address - Fax:919-661-6287
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7750101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional