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General NPI Number Information
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NPI Number | 1740776699
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Entity Type | Individual
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Provider Name | MADISON VEASEY LPCA, LCAS, NCC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 5882 FARINGDON PL STE 200
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City | RALEIGH
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State | NC
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Zip | 27609-3932
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Country | US
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Telephone | 919-473-6203
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Fax |
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Provider Business Mailing Address
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Address Line | 6708 ROSSFORD LN
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City | DURHAM
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State | NC
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Zip | 27713-6428
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Country | US
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Telephone | 919-698-3358
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-24597
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A14062
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License Number State | NC
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