Provider Demographics
NPI:1679948921
Name:NEALS, STEVEN A (LCSW, LPC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:NEALS
Suffix:
Gender:M
Credentials:LCSW, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5974 ROSIE LN SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2728
Mailing Address - Country:US
Mailing Address - Phone:803-270-4469
Mailing Address - Fax:
Practice Address - Street 1:5974 ROSIE LN SE
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-2728
Practice Address - Country:US
Practice Address - Phone:803-270-4469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACWS0061961041C0700X
GALPC008256101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional