Provider Demographics
NPI:1205418977
Name:NEAL, DONALD WELDON (MA, LPC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:WELDON
Last Name:NEAL
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 DINAH LN
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8127
Mailing Address - Country:US
Mailing Address - Phone:903-316-6063
Mailing Address - Fax:
Practice Address - Street 1:218 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-5715
Practice Address - Country:US
Practice Address - Phone:903-593-9141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX81758101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional