Provider Demographics
NPI:1689274045
Name:NEAL, JAMES SCOTT
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:SCOTT
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 1:51 BARTON CT
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-1699
Mailing Address - Country:US
Mailing Address - Phone:606-307-8609
Mailing Address - Fax:
Practice Address - Street 1:607 CLIFTY ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1765
Practice Address - Country:US
Practice Address - Phone:606-485-4730
Practice Address - Fax:606-485-4733
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY439128101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)