Provider Demographics
NPI:1578612156
Name:NEAL, DAVID A (LCSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:NEAL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MARKET PLACE BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2337
Mailing Address - Country:US
Mailing Address - Phone:865-212-2211
Mailing Address - Fax:833-314-0589
Practice Address - Street 1:140 MARKET PLACE BLVD STE E
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2337
Practice Address - Country:US
Practice Address - Phone:865-212-2211
Practice Address - Fax:833-314-0589
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1533218Medicaid