Provider Demographics
NPI:1497535702
Name:NEAL, SHELBY (NCC, LPC, ATR, CAADC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:NCC, LPC, ATR, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1761
Mailing Address - Country:US
Mailing Address - Phone:724-766-1579
Mailing Address - Fax:
Practice Address - Street 1:3910 CAUGHEY RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4096
Practice Address - Country:US
Practice Address - Phone:814-746-4307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional