Provider Demographics
NPI:1437332145
Name:MCNEAL, CHARLEA TRACEY (PHD MSW)
Entity Type:Individual
Prefix:DR
First Name:CHARLEA
Middle Name:TRACEY
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:PHD MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3518 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5228
Mailing Address - Country:US
Mailing Address - Phone:734-975-8694
Mailing Address - Fax:
Practice Address - Street 1:3518 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5228
Practice Address - Country:US
Practice Address - Phone:734-975-8694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010881601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical