Provider Demographics
NPI:1528120128
Name:VEATCH, MARY CONE (LPA LPC LSOTP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CONE
Last Name:VEATCH
Suffix:
Gender:F
Credentials:LPA LPC LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565
Mailing Address - Country:US
Mailing Address - Phone:281-332-3852
Mailing Address - Fax:
Practice Address - Street 1:122 NORTH MICHIGAN AVENUE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:281-332-3852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16382101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health