Provider Demographics
NPI:1508481086
Name:MCNEIL, WILLIAM SEAN (PLADC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SEAN
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 N 168TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2614
Mailing Address - Country:US
Mailing Address - Phone:402-753-7302
Mailing Address - Fax:
Practice Address - Street 1:3128 N 168TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2614
Practice Address - Country:US
Practice Address - Phone:402-753-7302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1761101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)