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General NPI Number Information
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NPI Number | 1063619963
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Entity Type | Individual
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Provider Name | LAURIE EVANS LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 118 LEE PARKWAY DR STE 470
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City | CHATTANOOGA
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State | TN
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Zip | 37421-1761
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Country | US
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Telephone | 423-762-1126
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25001
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City | CHATTANOOGA
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State | TN
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Zip | 37422-5001
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Country | US
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Telephone | 423-762-1126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CSW003778
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LSW0000004473
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LSW0000004473
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CSW003778
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 34003522A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LSW0000004473
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CSW003778
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW0000004473
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License Number State | TN
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Taxonomy #9
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW003778
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License Number State | GA
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Taxonomy #10
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34003522A
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License Number State | IN
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Taxonomy #11
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | LSW0000004473
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License Number State | TN
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Taxonomy #12
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | CSW003778
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License Number State | GA
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Taxonomy #13
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LSW0000004473
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License Number State | TN
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Taxonomy #14
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | CSW003778
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License Number State | GA
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Taxonomy #15
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LSW0000004473
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License Number State | TN
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