Provider Demographics
NPI:1629716675
Name:NEAL, JAMES PARKER
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PARKER
Last Name:NEAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4460 KEELEY CV
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-7519
Mailing Address - Country:US
Mailing Address - Phone:901-606-2232
Mailing Address - Fax:
Practice Address - Street 1:4460 KEELEY CV
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-7519
Practice Address - Country:US
Practice Address - Phone:901-606-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool