Provider Demographics
NPI:1275908717
Name:NEY, COLLEEN KING (LCSW)
Entity Type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:KING
Last Name:NEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:ANN
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:546 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1137
Mailing Address - Country:US
Mailing Address - Phone:650-493-1448
Mailing Address - Fax:
Practice Address - Street 1:546 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1137
Practice Address - Country:US
Practice Address - Phone:650-493-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA136531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical