Provider Demographics
NPI:1801398912
Name:VELD, DINA (MA, LPC)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:VELD
Suffix:
Gender:
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26185 WICK RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3082
Mailing Address - Country:US
Mailing Address - Phone:313-615-0005
Mailing Address - Fax:
Practice Address - Street 1:19306 ECORSE RD STE 102
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2262
Practice Address - Country:US
Practice Address - Phone:313-329-3829
Practice Address - Fax:313-307-0078
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401224675101YM0800X
MI6451022322101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health