Provider Demographics
NPI:1083620561
Name:NEAL, STEPHEN CLAY JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CLAY
Last Name:NEAL
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7958 W HAZELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-1861
Mailing Address - Country:US
Mailing Address - Phone:623-980-9330
Mailing Address - Fax:
Practice Address - Street 1:45 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-2264
Practice Address - Country:US
Practice Address - Phone:623-772-5156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ955073Medicare UPIN