Provider Demographics
NPI:1598925687
Name:CONNIE K MCNEIL, CLINICAL PSYCHOLOGIST PLLC
Entity Type:Organization
Organization Name:CONNIE K MCNEIL, CLINICAL PSYCHOLOGIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCNEIL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-472-3711
Mailing Address - Street 1:455 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1060
Mailing Address - Country:US
Mailing Address - Phone:914-472-3711
Mailing Address - Fax:914-723-7637
Practice Address - Street 1:455 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1060
Practice Address - Country:US
Practice Address - Phone:914-472-3711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2011-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014435-3103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
353135OtherMANAGED HEALTH NETWORK
NYV636D2OtherEMPIRE BC/BS
248092502OtherUNITED BEHAVORIAL HEALTH
9642616OtherGHI
P3152244OtherOXFORD HEALTH PLANS
719023000OtherMAGELLAN
NY680015163OtherRAILROAD MEDICARE
NY02145577Medicaid
2143084OtherCIGNA
NYS14435-2WOtherWORKER'S COMPENSATION BOARD
447585125OtherPOMCO
0007025351OtherAETNA
NY014435OtherHIP OF NEW YORK
NYVL3581Medicare PIN