MEDICARE: GAIL LEIGH EVANS LPC

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	101YP2500X	Professional Counselor	0701004796	VA

General Provider Information

NPI Number	:	1174848287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL LEIGH EVANS LPC

Provider Business Mailing Address
First Line	:	2702 BRAMBLETON AVE SW
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24015-4308
Country	:	US
Telephone Number	:	540-492-0773
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 BRAMBLETON AVE SW
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24015-4308
Country	:	US
Telephone Number	:	540-492-0773
Fax Number	:

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

Provider Enumeration Date	:	03/31/2010
Last Update Date	:	03/31/2026

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Directions to “ GAIL LEIGH EVANS LPC” Practice Location

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