Provider Demographics
NPI:1316184146
Name:NEALE, ELIZABETH LEIGH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LEIGH
Last Name:NEALE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:LEIGH
Other - Last Name:KUHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 2257
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-0357
Mailing Address - Country:US
Mailing Address - Phone:219-926-8320
Mailing Address - Fax:219-926-3524
Practice Address - Street 1:421 BENJAMIN LANE STE 202
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-0000
Practice Address - Country:US
Practice Address - Phone:502-690-8024
Practice Address - Fax:502-690-8090
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7235101YP2500X
KY129241103T00000X
NC4062103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6001260Medicaid