Provider Demographics
NPI:1770029555
Name:WIELOCH, VERENA (LCHMC, LCAS)
Entity Type:Individual
Prefix:
First Name:VERENA
Middle Name:
Last Name:WIELOCH
Suffix:
Gender:F
Credentials:LCHMC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SURREY GREEN DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-0010
Mailing Address - Country:US
Mailing Address - Phone:828-356-4899
Mailing Address - Fax:
Practice Address - Street 1:14 SURREY GREEN DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-0010
Practice Address - Country:US
Practice Address - Phone:828-356-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12599101YP2500X, 101YM0800X
NC23511101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)