Provider Demographics
NPI:1073914586
Name:NEELEY, REBECCA JEANETTE (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEANETTE
Last Name:NEELEY
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TUSCANNY DR UNIT B1
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5958
Mailing Address - Country:US
Mailing Address - Phone:240-831-4873
Mailing Address - Fax:240-831-4116
Practice Address - Street 1:100 TUSCANNY DR UNIT B1
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-5958
Practice Address - Country:US
Practice Address - Phone:240-831-4873
Practice Address - Fax:240-831-4116
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24308104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker