Provider Demographics
NPI:1265695753
Name:DALEY, VINETT A (MSW, LCAS)
Entity type:Individual
Prefix:MS
First Name:VINETT
Middle Name:A
Last Name:DALEY
Suffix:
Gender:F
Credentials:MSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 GALLENT HEDGE TRL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-6507
Mailing Address - Country:US
Mailing Address - Phone:919-924-5692
Mailing Address - Fax:
Practice Address - Street 1:113 GALLENT HEDGE TRL
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-6507
Practice Address - Country:US
Practice Address - Phone:919-924-5692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-06
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3190101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3190OtherLICENSED CLINICAL ADDICTION SPECIALIST (LCAS)