Provider Demographics
NPI:1518076447
Name:FEE, VIRGINIA ELAINE (PHD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:ELAINE
Last Name:FEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-3905
Mailing Address - Country:US
Mailing Address - Phone:704-986-0146
Mailing Address - Fax:
Practice Address - Street 1:1040 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-5017
Practice Address - Country:US
Practice Address - Phone:704-984-4910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3432103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSS09903Medicare UPIN
MS680000301Medicare ID - Type UnspecifiedPROVIDER # WITH PARADIGM