Individual provider Active NPI

Kelly J Veal, LPC

  • Professional Counselor
  • Lagrange, GA
National Provider Identifier
1720417140
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC006806 Issued in GA
Practice address
610 Ridley Ave
Lagrange, GA 30240-2236
Phone
(706) 594-8148
Fax
(706) 884-5056
NPI assigned
Nov 6, 2013
Last updated
Nov 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LPC006806 GA
Professional Counselor 101YP2500X LPC006806 GA Primary

Addresses

Primary practice location

610 Ridley Ave
Lagrange, GA 30240-2236

Mailing address

416 Park Ave
Lagrange, GA 30240-3034
Phone (706) 594-8148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815001392 GA Practitioner - Mental Health Counselor 3173997491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Veal Group, LLCGroup PAC ID 2264806587, 5 clinicians

Practice addresses (Care Compare)

403 Ridley Ave
Lagrange, GA 30240-2231
Phone (706) 756-1970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LPC006806GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Veal Group, LLC Addiction (Substance Use Disorder) CurrentSince Sep 5, 2022 Accepting new patients
Lagrange Clinic of Chiropractic Incorporated Past Accepting new patients
Counseling Services of Lagrange, Inc. Past Accepting new patients

Locations

401 Ridley Ave
Ste C
Lagrange, GA 30240
Phone (706) 616-1363

403 Ridley Ave
Lagrange, GA 30240
Phone (706) 756-1970

403 Ridley Ave
Ste C
Lagrange, GA 30240

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1720417140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 PARK AVE",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403034",
            "telephone_number": "706-594-8148",
            "fax_number": "706-884-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 RIDLEY AVE",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402236",
            "telephone_number": "706-594-8148",
            "fax_number": "706-884-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEAL",
        "first_name": "KELLY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "LPC006806",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.