Provider Demographics
NPI:1164976163
Name:VEAL, SYLVIA ROSE (LPC)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:ROSE
Last Name:VEAL
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 1:1818 S CURTIS RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-2709
Mailing Address - Country:US
Mailing Address - Phone:503-997-9857
Mailing Address - Fax:
Practice Address - Street 1:6855 W FAIRVIEW AVE
Practice Address - Street 2:SUITE #120
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8046
Practice Address - Country:US
Practice Address - Phone:208-323-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-6285101YM0800X
IDLCPC-7036101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health