Provider Demographics
NPI:1215955257
Name:VEAL, IMA E (LPC)
Entity type:Individual
Prefix:
First Name:IMA
Middle Name:E
Last Name:VEAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6760 POPPY HILLS LANE
Mailing Address - Street 2:#634
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-8549
Mailing Address - Country:US
Mailing Address - Phone:980-229-9531
Mailing Address - Fax:866-286-9964
Practice Address - Street 1:6760 POPPY HILLS LANE
Practice Address - Street 2:#634
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8549
Practice Address - Country:US
Practice Address - Phone:980-229-9531
Practice Address - Fax:866-286-9964
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4966101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102789Medicaid