Provider Demographics
NPI:1831996685
Name:EVANS, SHIONDA M (LCSW)
Entity type:Individual
Prefix:
First Name:SHIONDA
Middle Name:M
Last Name:EVANS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 ROCKCREEK LN
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-2443
Mailing Address - Country:US
Mailing Address - Phone:757-679-0220
Mailing Address - Fax:
Practice Address - Street 1:3306 ROCKCREEK LN
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-2443
Practice Address - Country:US
Practice Address - Phone:757-679-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040180601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical