Provider Demographics
NPI:1619917358
Name:STEED, VICKI COPELAND (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:COPELAND
Last Name:STEED
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:COPELAND
Other - Last Name:BAME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:109 PINEYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-3434
Mailing Address - Country:US
Mailing Address - Phone:336-475-0852
Mailing Address - Fax:336-475-0445
Practice Address - Street 1:109 PINEYWOOD ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-3434
Practice Address - Country:US
Practice Address - Phone:336-475-0852
Practice Address - Fax:336-475-0445
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0005831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC79531OtherBCBS
NC2861292BMedicare ID - Type Unspecified