Provider Demographics
NPI:1366966244
Name:IVEE, THE
Entity type:Individual
Prefix:
First Name:THE
Middle Name:
Last Name:IVEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANYOSAL
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPH, MBA
Mailing Address - Street 1:PO BOX 621091
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-0118
Mailing Address - Country:US
Mailing Address - Phone:424-283-7122
Mailing Address - Fax:
Practice Address - Street 1:630 CALVERT ST STE 1102
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5036
Practice Address - Country:US
Practice Address - Phone:984-212-3177
Practice Address - Fax:984-212-3177
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL0601199101YA0400X, 101YM0800X
NCHC3291374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No374U00000XNursing Service Related ProvidersHome Health Aide