MEDICARE: MARLA LENVIEL 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	0701015402	VA

General Provider Information

NPI Number	:	1598637688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLA LENVIEL LPC

Provider Business Mailing Address
First Line	:	4310 FOX CROFT CIR
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-8944
Country	:	US
Telephone Number	:	434-607-0718
Fax Number	:

Provider Business Practice Location Address
First Line	:	2545 SANFORD AVE SW
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24014-1123
Country	:	US
Telephone Number	:	540-258-4065
Fax Number	:

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

Provider Enumeration Date	:	09/19/2025
Last Update Date	:	09/19/2025

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