Provider Demographics
NPI:1477614063
Name:MCNEELY, STACY RENAE (MSW, LMSW, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:RENAE
Last Name:MCNEELY
Suffix:
Gender:F
Credentials:MSW, LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 W 8TH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-2701
Mailing Address - Country:US
Mailing Address - Phone:616-805-8341
Mailing Address - Fax:616-258-2200
Practice Address - Street 1:36 W 8TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-2701
Practice Address - Country:US
Practice Address - Phone:616-805-8341
Practice Address - Fax:616-258-2200
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010884651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical