Basic Information
Provider Information
NPI: 1700390895
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCVEIGH
FirstName: CELESTE
MiddleName: ALLYN
NamePrefix:  
NameSuffix:  
Credential: LCSWA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 205 MEMORIAL DR
Address2:  
City: PINEHURST
State: NC
PostalCode: 283748712
CountryCode: US
TelephoneNumber: 9102956853
FaxNumber: 9102959183
Practice Location
Address1: 205 MEMORIAL DR
Address2:  
City: PINEHURST
State: NC
PostalCode: 283748712
CountryCode: US
TelephoneNumber: 9102956853
FaxNumber: 9102959183
Other Information
ProviderEnumerationDate: 11/28/2017
LastUpdateDate: 11/28/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XP011309NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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