Provider Demographics
NPI:1265869382
Name:FOWLER, VEEDA L (LCPC, LPC, NCC)
Entity type:Individual
Prefix:
First Name:VEEDA
Middle Name:L
Last Name:FOWLER
Suffix:
Gender:F
Credentials:LCPC, LPC, NCC
Other - Prefix:
Other - First Name:VEEDA
Other - Middle Name:L
Other - Last Name:RINKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2403 LITTLE ROUND TOP DR
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3131
Mailing Address - Country:US
Mailing Address - Phone:618-567-3815
Mailing Address - Fax:
Practice Address - Street 1:2615 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-3915
Practice Address - Country:US
Practice Address - Phone:618-567-3815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional