Provider Demographics
NPI:1629067772
Name:SAUNDERS, EVELYN GAIL (LPC)
Entity Type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:GAIL
Last Name:SAUNDERS
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 1:1000 COMMERCIAL LN
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8148
Mailing Address - Country:US
Mailing Address - Phone:757-942-1069
Mailing Address - Fax:
Practice Address - Street 1:1000 COMMERCIAL LN
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8148
Practice Address - Country:US
Practice Address - Phone:757-942-1069
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002539101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA282482OtherHEALTHKEEPERS
VA4945310OtherVA PREMIER
VA250264OtherMAMSI
VAO87320OtherSENTARA FAMILY CARE
VA5401615Medicaid