Provider Demographics
NPI:1912094905
Name:MCGEE, VICKY L (LPA)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:L
Last Name:MCGEE
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 HOLLY SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9634
Mailing Address - Country:US
Mailing Address - Phone:919-673-3122
Mailing Address - Fax:919-567-0152
Practice Address - Street 1:1140 HOLLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9634
Practice Address - Country:US
Practice Address - Phone:919-673-3122
Practice Address - Fax:919-567-0152
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2492103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107350Medicaid