Provider Demographics
NPI:1093998841
Name:VEITCH, PATRICIA M (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:VEITCH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 KUYKENDALL LN
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-1167
Mailing Address - Country:US
Mailing Address - Phone:304-530-7755
Mailing Address - Fax:304-530-7756
Practice Address - Street 1:112 KUYKENDALL LN
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-1167
Practice Address - Country:US
Practice Address - Phone:304-530-7755
Practice Address - Fax:304-530-7756
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG09172104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD58956180Medicaid
MD941L70Medicare UPIN