Provider Demographics
NPI:1609967439
Name:NEILL, JUANITA A (MACC,LPC)
Entity Type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:A
Last Name:NEILL
Suffix:
Gender:F
Credentials:MACC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BARTON DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-2517
Mailing Address - Country:US
Mailing Address - Phone:412-673-5800
Mailing Address - Fax:412-673-5805
Practice Address - Street 1:1101 HARTMAN ST
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-1500
Practice Address - Country:US
Practice Address - Phone:412-672-5800
Practice Address - Fax:412-672-5805
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004170101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional