Provider Demographics
NPI:1689328346
Name:NEO, DEBBIE SHANNA (LSW)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:SHANNA
Last Name:NEO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3721 NICOYA CT
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-9353
Mailing Address - Country:US
Mailing Address - Phone:330-284-0468
Mailing Address - Fax:
Practice Address - Street 1:620 ALUM CREEK DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1653
Practice Address - Country:US
Practice Address - Phone:614-412-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.20050161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical