Provider Demographics
NPI:1043690563
Name:HAM, NEYSIA DREW (LPCA)
Entity Type:Individual
Prefix:
First Name:NEYSIA
Middle Name:DREW
Last Name:HAM
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE NORMAN CR
Mailing Address - Street 2:APT D
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031
Mailing Address - Country:US
Mailing Address - Phone:864-293-4027
Mailing Address - Fax:
Practice Address - Street 1:20010 ONE NORMAN CIR
Practice Address - Street 2:APT D
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6913
Practice Address - Country:US
Practice Address - Phone:864-293-4027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health