Provider Demographics
NPI:1952676447
Name:VEIERSTAHLER, NORMAN EDMUND (MA, LPC, NCC, CCTP)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:EDMUND
Last Name:VEIERSTAHLER
Suffix:
Gender:M
Credentials:MA, LPC, NCC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S DOBSON RD UNIT 187
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-1822
Mailing Address - Country:US
Mailing Address - Phone:480-567-5070
Mailing Address - Fax:
Practice Address - Street 1:880 N COLORADO ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3419
Practice Address - Country:US
Practice Address - Phone:480-820-0825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13388101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional