Provider Demographics
NPI:1750956058
Name:CEA, DANA
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BROOKSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-8480
Mailing Address - Country:US
Mailing Address - Phone:336-817-1525
Mailing Address - Fax:
Practice Address - Street 1:118 BROOKSIDE WAY
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:NC
Practice Address - Zip Code:27863-8480
Practice Address - Country:US
Practice Address - Phone:252-618-6852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health