Provider Demographics
NPI:1891295192
Name:NEAL, ELI ALEXANDER (LCMHCA)
Entity Type:Individual
Prefix:
First Name:ELI
Middle Name:ALEXANDER
Last Name:NEAL
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4113
Mailing Address - Country:US
Mailing Address - Phone:336-520-0960
Mailing Address - Fax:
Practice Address - Street 1:227 W MOREHEAD ST STE 230
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-3872
Practice Address - Country:US
Practice Address - Phone:336-908-3927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13380101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional