Provider Demographics
NPI:1497989065
Name:MCNEELY, PAULA (LSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:MCNEELY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S MAIN ST
Mailing Address - Street 2:RM 1500
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4802
Mailing Address - Country:US
Mailing Address - Phone:817-321-4811
Mailing Address - Fax:817-321-4809
Practice Address - Street 1:1101 S MAIN ST
Practice Address - Street 2:RM 1500
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4802
Practice Address - Country:US
Practice Address - Phone:817-321-4850
Practice Address - Fax:817-321-4809
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical