Provider Demographics
NPI:1932556248
Name:VAN DYKE, MARIA ARACELI (LCMHC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ARACELI
Last Name:VAN DYKE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:CELI
Other - Middle Name:
Other - Last Name:ANDRADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:8600 ANDREW CAMEGIE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:704-988-0956
Mailing Address - Fax:304-254-9099
Practice Address - Street 1:8600 ANDREW CAMEGIE DRIVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:704-988-0956
Practice Address - Fax:304-254-9099
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1442101YP2500X
FLMH18538101YP2500X
NC17488101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional