Provider Demographics
NPI:1053475145
Name:NEIGHBORS, CLELL LEE (LAC, LCSW)
Entity Type:Individual
Prefix:MR
First Name:CLELL
Middle Name:LEE
Last Name:NEIGHBORS
Suffix:
Gender:M
Credentials:LAC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 POSTAL SERVICE LOOP
Mailing Address - Street 2:BOX 7499
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99505
Mailing Address - Country:US
Mailing Address - Phone:907-384-3031
Mailing Address - Fax:
Practice Address - Street 1:724 POSTAL SERVICE LOOP STOP 7499
Practice Address - Street 2:
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99505-7499
Practice Address - Country:US
Practice Address - Phone:907-384-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1132101YA0400X
AK10201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)