Provider Demographics
NPI:1699097303
Name:MCDOWELL, VELECIA VELENCIA (LPC)
Entity type:Individual
Prefix:
First Name:VELECIA
Middle Name:VELENCIA
Last Name:MCDOWELL
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 1:104 AUTUMN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4540
Mailing Address - Country:US
Mailing Address - Phone:770-412-0912
Mailing Address - Fax:
Practice Address - Street 1:6315 GARDEN WALK BLVD
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2628
Practice Address - Country:US
Practice Address - Phone:770-991-7420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health