Provider Demographics
NPI:1609515758
Name:MCNEELEY, MILES (LCSW)
Entity Type:Individual
Prefix:
First Name:MILES
Middle Name:
Last Name:MCNEELEY
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 1:4300 LONG BEACH BLVD STE 440
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2018
Mailing Address - Country:US
Mailing Address - Phone:310-743-4142
Mailing Address - Fax:
Practice Address - Street 1:4300 LONG BEACH BLVD STE 440
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2018
Practice Address - Country:US
Practice Address - Phone:310-743-4142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical