MEDICARE: MS. NANCY EVANS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	0812000044	VA
2	1041C0700X	Clinical Social Worker	0904004018	VA

General Provider Information

NPI Number	:	1821091927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY EVANS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1533
Second Line	:
City	:	STEPHENS CITY
State	:	VA
Zip	:	22655
Country	:	US
Telephone Number	:	540-869-2008
Fax Number	:	540-869-2008

Provider Business Practice Location Address
First Line	:	5441 MAIN ST
Second Line	:	RM 205
City	:	STEPHENS CITY
State	:	VA
Zip	:	22655-2800
Country	:	US
Telephone Number	:	540-869-2008
Fax Number	:	540-869-2008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/11/2025

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