1265869382 NPI number — VEEDA L. FOWLER MA, LCPC, LPC, NCC

NPI Number: 1265869382
Health Care Provider/Practitioner: VEEDA L. FOWLER MA, LCPC, LPC, NCC

NPI Number : 1265869382 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265869382",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FOWLER",
    "FirstName": "VEEDA",
    "MiddleName": "L.",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA, LCPC, LPC, NCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RINKEL",
    "OtherFirstName": "VEEDA",
    "OtherMiddleName": "L.",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2403 LITTLE ROUND TOP DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EDWARDSVILLE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "62025-3131",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1150 GRAHAM RD STE 101-102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLORISSANT",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63031-8077",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "618-567-3815",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/03/2013",
    "LastUpdateDate": "09/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "180005501",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "2001030203",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}