Provider Demographics
NPI:1669242053
Name:VEASEY, MICHAEL CAMERON (LPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CAMERON
Last Name:VEASEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:MICK
Other - Middle Name:CAMERON
Other - Last Name:VEASEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:6600 LYNDON B JOHNSON FWY STE 210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6546
Mailing Address - Country:US
Mailing Address - Phone:972-561-9180
Mailing Address - Fax:
Practice Address - Street 1:6600 LYNDON B JOHNSON FWY STE 210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6546
Practice Address - Country:US
Practice Address - Phone:972-561-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health