Provider Demographics
NPI:1578064796
Name:NEECE, NANCY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:NEECE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BONNE TERRE
Mailing Address - State:MO
Mailing Address - Zip Code:63628-3578
Mailing Address - Country:US
Mailing Address - Phone:573-200-1367
Mailing Address - Fax:
Practice Address - Street 1:12 N ALLEN ST
Practice Address - Street 2:
Practice Address - City:BONNE TERRE
Practice Address - State:MO
Practice Address - Zip Code:63628-1210
Practice Address - Country:US
Practice Address - Phone:573-315-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-22
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016041625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional