Provider Demographics
NPI:1457503260
Name:NEELEY, DULCY K (LCSW)
Entity Type:Individual
Prefix:
First Name:DULCY
Middle Name:K
Last Name:NEELEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DULCY
Other - Middle Name:K
Other - Last Name:NEELEY-BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:636 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4442
Mailing Address - Country:US
Mailing Address - Phone:541-231-1277
Mailing Address - Fax:541-753-0184
Practice Address - Street 1:636 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4442
Practice Address - Country:US
Practice Address - Phone:541-231-1277
Practice Address - Fax:541-753-0184
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500601281Medicaid