Provider Demographics
NPI:1437636073
Name:NEAL, JESSI NICHOL (MSW U/S)
Entity Type:Individual
Prefix:MS
First Name:JESSI
Middle Name:NICHOL
Last Name:NEAL
Suffix:
Gender:F
Credentials:MSW U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:BARNSDALL
Mailing Address - State:OK
Mailing Address - Zip Code:74002
Mailing Address - Country:US
Mailing Address - Phone:918-847-3527
Mailing Address - Fax:918-777-9018
Practice Address - Street 1:401 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:BARNSDALL
Practice Address - State:OK
Practice Address - Zip Code:74002
Practice Address - Country:US
Practice Address - Phone:918-847-3527
Practice Address - Fax:918-777-9018
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK63011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical