Provider Demographics
NPI:1568530657
Name:NEEL, SHAWN ROBERT (LMFT)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:ROBERT
Last Name:NEEL
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 UNIVERSITY AVE W
Mailing Address - Street 2:STE 425
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3598
Mailing Address - Country:US
Mailing Address - Phone:651-243-8200
Mailing Address - Fax:651-301-8806
Practice Address - Street 1:1919 UNIVERSITY AVE W
Practice Address - Street 2:STE 425
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3598
Practice Address - Country:US
Practice Address - Phone:651-243-8200
Practice Address - Fax:651-301-8806
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1260106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist