Provider Demographics
NPI:1639229024
Name:MCNEALEY, BILLIE D (PSYD, ABSNP, NCSP)
Entity Type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:D
Last Name:MCNEALEY
Suffix:
Gender:F
Credentials:PSYD, ABSNP, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SQUADRON LINE RD
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1636
Mailing Address - Country:US
Mailing Address - Phone:860-683-1047
Mailing Address - Fax:
Practice Address - Street 1:44 SQUADRON LINE RD
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-1636
Practice Address - Country:US
Practice Address - Phone:860-683-1047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2009-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002293103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist