Provider Demographics
NPI:1619332988
Name:MCNEECE, MICHAEL COWAN CRIPPEN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:COWAN CRIPPEN
Last Name:MCNEECE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:MR
Other - First Name:MICKEY
Other - Middle Name:COWAN CRIPPEN
Other - Last Name:MCNEECE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19581 HARDY ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1586
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9315 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-1260
Practice Address - Country:US
Practice Address - Phone:313-937-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical